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.

5 comments:

  1. Hello,

    Interesting information. Remember as you read my comments, that most of what I say is light hearted and intended to make more of a thinking process out of this as opposed to an emotional process. Here are my comments:



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    *** YOU SAID: The blue is what I should hear aided once my hearing aids are reprogrammed for maximum gains. *** END YOU SAID
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    The key word here is "should" ... I really have no experience with “new” HA’s but I do know that my HA’s were maxed out and even today, I am told by several independent audiologist and Medical Doctors that the kind of power gain you are looking at is not typical. I do hope for the best for you, it would be awesome if it works and I would consider trying a like HA in my left ear later, so keep posting, but I am somewhat skeptical (just because I’m an electronics engineer - we all have bad attitudes !) ;-)

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    *** YOU SAID: 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*** END YOU SAID
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    That should work, but it’s gonna sound really, really weird to you. And there’s actually no way to completely translate a high frequency into a lower frequency with out creating missing parts of the audio. Imagine Mickey Mouse sounding like a baritone who slightly stutters. This is the net result of down converting an audio frequency.



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    *** YOU SAID: 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.*** END YOU SAID
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    I’d love to pull out of my pocket $3K or $4K per ear for hearing aides that my insurance won’t cover. I’d love to get limited use of HAs for only a couple of years and then have to get CIs later and pay an additional $5K in insurance deductibles. Makes sense, yes?

    Practicality has it place, especially where money, time, and results are concerned. Again, I’m not taking this on a personal level, rather my intent is to show how one-sided and HA-centric the argument is. Sure, this may be the best solution for you, but consider a more central viewpoint. My CI blog will never promote CI as a solution for everyone with the same hearing loss profile as I have. My CI blog’s intent is to inform and to entertain, and not to be a commercial or a soap-box for any given product or procedure.



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    *** YOU SAID: I don't struggle with speech and neither should anyone with equal or better hearing than me.*** END YOU SAID
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    Oh, my. Oh, Boy....

    This is something very similar to what my wife says to me, and she has perfect hearing. It’s the fatalistic “I am the world” syndrome. The logic in use here goes something like this: “Because I have strong vocal chords and can sing the star-spangled-banner, anyone with strong vocal chords can sing the star-spangled-banner.”

    What about having pitch control, breathing control, rhythm, and the ability to be artistic?

    In like sense, lip reading is an art and needs to be practiced and learned. If someone lost their hearing within a few days, and by chance their hearing audiogram matched yours, they still would not be able to lip read or communicate effectively. Lots of people can never learn to lip read. Some are better than others. There are just too many variants to make a statement like you made.

    Also, you should try to read lips of many culturally different people (Chinese, Korean, Japanese, Russian, French, Great Britain, Indian). I think you will find that you don’t do as well as you might think. My wife is Chinese and speaks English with a Russian accent that’s laced with the 4 tonal qualities of Mandarin Chinese. And my mom, who has perfect hearing, has a hard time understanding my wife. Can you imagine lip reading that all day? …. and you should try to learn to lip read Korean people. Most native Han Guk speakers don’t move lips very much, they speak by creating sounds and movements deep in the throat, not the lips. Ever tried to read necks? I can. The truth is that decoding speech is not a “one-fits-all” glove and there are emotional, psychological, and physical traits to consider in all cases.


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    *** YOU SAID: 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.*** END YOU SAID
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    The statement is irrelevant and is very centralistic. I could pass for a hearing person less than 9 months ago. What does it matter? Again, everyone is different in skill and gifts.




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    *** YOU SAID: 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.*** END YOU SAID
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    What definition and what standard are you using to set apart those “who really need them” from “those who do not?” How do you neatly draw the line and why should a person like me (who can hear some low frequency sounds) be forced to use a HA instead of a CI based on your arbitrary set of standards? (I’m yanking your chain here of course… I’m not taking your comments personally, I’m just making hash for the thought process). Why should my head vibrate from the sheer power of an external HA when I could make an informed trade off for a more passive CI? Lots to consider here.

    We should all be careful when making statements like this. When we do, we are sailing in very dangerous waters. The decision to use a CI or not to use a CI should be made by the individual, no “but’s” allowed.

    I apologize if I offend; that’s not my intent. I just hope to help you see a different view.

    All the best,

    …dan…

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  2. Thanks for your long comment, here's my long reply! I don't get offended easily and was hoping you were the one who didn't get offended :)

    1. So you never tried the "best, latest and greatest" HAs? I thought it was a basic requirement before anyone can become a CI candidate! It's not a fair comparsion between older, weaker HAs and CI. The newest HAs can give a person another 10db to 20db more gain and a bunch more features. He could possibly be hearing as good or better than with CI.

    2. My power gain isn't typical but it's the only choice for profoundly deaf people. Everyone should be trying all the most powerful HAs before even considering CI. It used to be that way in the past, it should still be the case today.

    3. Ill find out how good transposition really is. I see alot of hype on the net. If transposition turns out to be nearly useless, ill just upgrade my Phonak Naida V UP HAs in a year or two when a newer model from any company comes out.

    4. I agree, insurance companies are dumb for not covering HAs. They would rather spend $50,000 on a CI than $2000 on a HA! I know a few people who said theyd rather get a new HA but can't afford the cost and CI is free to them so they are getting a CI instead.

    5. If you haven't tried the best HAs, you have no idea how much benefit they would be. But since your hearing is drastically better than mine, you should be hearing normally with my kind of HAs in all but the highest frequencies. By the time you really need CIs, technology will be much better and the risks of surgury further reduced.

    6. I am not against CI and understand some people geting CI. Most of the CI blogs I read, those people have much worse hearing than mine. I was shocked to see people with moderate hearing loss getting approved for CI!

    7. Well I agree that reading lips is a valuable skill. So is sign language(although im 100% oral) I understand about 90% of the people im talking to, the other 10% don't speak clearly, even hearing people would have a hard time understanding those people.

    8. It does take skill to learn how to hear properly with a HA and it's no different with a CI either. My own audiologist who sold me those HAs doesn't believe any CI would benefit me over the HAs he sold me. He's going to reprogram my HAs so I hear normal to near normal.

    9. CIs are for severe-profoundly deaf people. Insurance companies require a 70db loss, sloping down to 90+ db. You do have 90+ db loss in some frequencies but in other frequencies, your loss is much below 70db, in fact it's mild-moderate.

    It's not so much as forcing as not qualifying to be a candidate. I am not sure even I would be a CI candidate, if I am not a candidate, this means I hear too well so why risk a CI?

    A CI is not about deciding if it's possibly better than HA but if it's the *only* option. It used to be that way before candidacy standards became incredibly lax. The issue is that CIs involve risky surgery and there's many other risks involved. The cost is also great for the insurance or you.

    Because of the lax standards, many people are now candidates but many of them could still benefit just fine from powerful HAs. My dad says surgeons don't care, they make a fortune. Insurance companies are losing lots of money and they are just raising their rates for the majority to subsidize the growing minority who are opting for CI. I really wish insurance companies would wake up and pay for HAs!

    10. My condolences for your progressive hearing loss, but what if it stopped progressing or even improved(if possible?) What's the hurry getting CI when better CI technology is around the corner? My audiologist doesn't think I will benefit from today's CI technology, he would be horrified if you told him you got a CI! He would of told you that he could of sold and programmed HAs that give better results than CI!

    11. I will answer your replies you put in your blog on your blog. The answers above address the replies you put in my blog. Thanks for your time!

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  3. Again, look at your aided audiogram, you are missing TONS of speech sounds. Why settle for less???

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  4. I am indeed missing some speech sounds, but many(but not all, a few get very lucky) of the CI audiograms ive seen, they are also missing speech sounds. CI wearers hear the consonants better while I hear the vowels better. But even people with my audiogram can hear alot of speech, please see my above post of this man with profound hearing loss who scores over 90% speech understanding!

    Then there is the whole issue of environmental sounds which even my CI friend agrees is as important as speech. Ive noticed alot of CI wearers hear low frequencies worse, having traded those for high frequencies. 75% of sounds happen to be low frequencies.

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  5. That's very interesting, thank you for sharing your audiogram! I'm planning to get a copy of mine to share, too.

    audiogram Merrimac Ma

    ReplyDelete