Friday, April 24, 2009

Some people who got CI have unaided audiograms I would rather have instead of CI!

Most people who qualify for a CI have profound hearing loss. Most profoundly deaf people don't have any hearing above 2000Hz. But since 2005, CI criteria has become way too lax and I am seeing moderately HOH people somehow getting CI. I am anonymously(not revealing who they are nor any personal information) blogging their audiograms along with facts, stats and opinions. This is not meant to offend, just be a learning experience for me and everyone else.

Below, I have found from a Google search,  some audiograms of people who got CI. I respectfully disagree with their choice. But I am never rude to anyone! They have so much residual hearing that I would be better off having their residual hearing and wearing HAs than getting CIs! Not only that, they would be able to hear plenty of low frequency environmental sounds unaided, something I am sorely missing out on! I do not understand why they can't be happy with their hearing that is leaps and bounds better than mine?

I did notice that they all had in common a desire to increase their % on speech comphrension/recognition. This is understandable, even by me. What I am confused is how are they having so much trouble despite having a great deal of residual hearing? My audiologist told me if my hearing was 20db better, I would hear perfectly with hearing aids. Those people happen to have 20db or more hearing than I do so you can see why I wish I had their audiograms!

Speech can be accessed by reading lips, sign language and written language. When I talk to others I look at their lips instead of eyes and most people don't even realize I am severely deaf. I did let some of them know as I am not hiding anything. It doesn't bother anyone so why should it bother me? Personally, I find it more inconveniencing not to hear much unaided and even aided not to hear as well as those with better hearing than me. I am missing out on some environmental sounds and there's no way to lip read sounds, just speech.

Ive noticed that some people do not try the best HAs available before getting CI. While I understand everyone wishes to hear better, trying the best HAs is a requirement that should be mandatory. This is exactly what I am doing and my own audiologist doesn't recommend a CI for me, he certainly won't recommend a CI for anyone with better hearing. When my HAs are reprogrammed, he feels I could achieve 15db aided in the low frequencies and up to 30db aided in the mid frequencies. Transposition, if it works for me will shift the high frequencies down to where I can hear them. 

Speaking of transposition, this is something everyone should try. If it works for you, great! Even if not, I don't understand the obsession with the high frequencies. Only 10% of the speech banana takes place at 2000Hz and above. I am able to understand 70% of what my dad says without lipreading. Ive seen others without high frequency hearing score way above 40% speech(HINT is one such test)  I probably would not be a CI candidate unless I score 40% or worse. But I am not getting a CI candidacy test as I don't need CIs at this time, I will wait for better technology or unless my hearing gets alot worse.

I am not against CI and you have to understand that I would get a CI myself if the benefits vs. risk ratio was favorable enough. CI is real surgery with many different kinds of risks. It's also a permanent choice and the majority will lose most or all their residual hearing in the implanted ear.

Still considering that CIs usually destroy your natural unaided hearing, this is not something I would trade away, especially when it's enough to hear plenty of environmental sounds unaided! My loss starts too high for me to hear the majority of environmental sounds unaided. I essentally am deaf without my HAs and live in a silent world. That person apparently wasn't happy with having no high frequency hearing. I used to be that way but now I believe high frequencies are overrated.

For all audiograms, red is unaided scores, blue is HA(Phonak Naida V UP), green is CI. Note that the HA scores are the theoratical maximum they can achieve with the best HAs. Those aided scores are what I could possibly have if I had their unaided audiogram. I recreated those audiograms from different CI blogs and sources and made them easy to read using paint. I did have to extrapolate 125Hz and some half octive frequencies that werent tested on the audiometer for some of the below audiograms. No personal information has been disclosed about anyone, all info I found was already made public by the respective authors. Everything on my blog is for educational purposes only.

You may leave me a comment as long as it's not rude or offensive. Feel free to debate, agree or disagree with my assertions and opinions. Maybe I can learn something. Everything I have learned at this point is on my blog.

Audiogram 1:



My opinion and comment: This person has a moderate low frequency loss that slopes precipitously down to nothing. That 1500Hz result might even be a response based on the cochlear dead region phenomenon rather than true hearing at this point. That person did respond at 120db in some of the high frequencies which further supports the dead cochlear zone theory. Youd just hear a noiselike sound, distortion or wooshing of air and still respond, thinking it was a puretone being played. The person failed to respond to 1500Hz in one ear. I am giving the benefit of the doubt and recording the 1500Hz as valid but nothing above that. The person even mentioned in the blog that the hearing quickly whittled down to nothing. No one would argue that 120db at 1500Hz is pratically useless and nothing to get excited about. Any further progression of HL would wipe out the residual hearing at 1500Hz. That could have made sense as another reason for CI, but still there was so much low frequency hearing!

Doing the math, that person would have with HAs:

125Hz-500Hz 100% of 60%=60% access to speech
500Hz-2000Hz 67% of 30%=20% access to speech
2000Hz-8000Hz 0% of 10%=0% access to speech
Total access to speech is 80% with HAs

Doing the math, that person would have with CIs:

125Hz-500Hz 67% of 60%=40% access to speech
500Hz-2000Hz 100% of 30%=30% access to speech
2000Hz-8000Hz 80% of 10%=8% access to speech
Total access to speech is 78% with CIs

Additional comments: This is about the same. That person could have tried the best HAs and heard much better than CI in the low frequencies. CI was worse in the lows but better in the mids and highs. I would never get CIs for myself if I had that audiogram. I would prefer that person's HA scores than CI scores on myself in my opinion. If I could choose to have CI or to have that person's audiogram and wear HAs, I would choose that audiogram and wear HAs.

Audiogram 2:


My opinion and comment: This person has a moderate low frequency loss that slopes down to 120db at 4000Hz. At least that person still has minimal high frequency hearing. My audiologist correctly says a loss of 120+ db is useless for any HA. It is not even certain that person would respond to any tones at 4000Hz during an aided test, besides it would be outside the speech banana anyway. For the matter, even the 3000Hz is pretty much useless save for the possibly of faintly hearing a whistle or birds singing at close range. It is no surprise that some of today's audiometers, including the one that tested me on March reach up to a maximum at 115db at 3000Hz. Interestingly, the other ear is actually worse in the low frequencies but better in the highs. It had a cookie bite audiogram(80, 95, 100, 95, 85, 75) More interestingly, it actually scored better in speech. I am not surprised since that person was still able to be aided well enough to access speech in the lows. A 65db gain at 250Hz would yield 15db aided.

Doing the math, that person would have with HAs:

125Hz-500Hz 100% of 60%=60% access to speech
500Hz-2000Hz 95% of 30%=28.5% access to speech
2000Hz-8000Hz 10% of 10%=1% access to speech
Total access to speech is 89.5% with HAs

Doing the math, that person would have with CIs:

125Hz-500Hz 80% of 60%=48% access to speech
500Hz-2000Hz 95% of 30%=28.5% access to speech
2000Hz-8000Hz 80% of 10%=8% access to speech
Total access to speech is 84.5% with CIs

Additional comments: This is 5% worse for speech but much worse for environmental sounds. That person could have tried the best HAs and heard much better than CI in the low frequencies. CI was worse in the lows but better in the mids and highs. I would never get CIs for myself if I had that audiogram. I would prefer that person's HA scores than CI scores on myself in my opinion. If I could choose to have CI or to have that person's audiogram and wear HAs, I would choose that audiogram and wear HAs. That person obviously doesn't care for environmental sounds.

Audiogram 3:



My opinion and comment: This person has a moderate low frequency loss that slopes down to 115db at 2000Hz. That audiogram is actually similar to mine but with only a moderate loss instead of the severe loss I have. Thus that person can still hear some sounds unaided while I can't. That's the main advantage over my audiogram. The other advantage is the possibility of getting to 0db aided, something my audiologist said was not possible for me. He says 15db aided in the lows and 30db in the mids is realistic for me. This would still make me happy and not feel the need for a CI as no one gets to 0db with CI either, they get between 25-40db with CI so this would only help in the highs of 2000Hz and above. That's something I might achieve with transposition and even if not, I can live with that. Ive never really heard the highs so I don't know what they are like and therefore don't know what id be missing. But ive been told by hearing people that high frequencies are annoying and that they would give up the highs if it won't affect their speech.

My audiogram:



My opinion and comment: My own audiogram is similar to audiogram 3 but I am missing alot more of the low frequencies. Today, I am not even sure ill hear 2000Hz. Ive seen my audiograms in the past and had more tests recently and my lows have remained basically unchanged. I lost whatever little high frequency I had as a kid and lost most of my mids. They were never great to begin with a 100db loss at 1KHz to 6KHz straight across. But at least the most important frequencies, the lows are still in the severe range instead of profound range. The lows alone account for 60% of speech and 75% of sounds. So you can see why id love to have the audiograms you see above. It would make the biggest difference in speech and sounds as well as being able to hear unaided.

8 comments:

  1. You have no idea what you are talking about.

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  2. Then explain. Every audiogram above is ten times better than my audiogram.

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  3. Very detailed and interesting post! :)

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  4. May I ask you guys: Would any of you still have gotten a CI if you had the above audiograms? I personally would rather have HA and their audiograms than a CI. If I could trade my hearing for their much improved hearing, id pay the deductable for their CI and ill benefit immensely from HA with their audiograms. Id also hear some sounds unaided.

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  5. Um, you are so dumb. Seriously, you have this upside down and backwards. Go to audiology school and get a real education than on google.

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  6. jstarrynite13, don't be a jerk. I bet you don't even know what's going on at all. You shouldn't criticize someone for actually trying to learn.

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  7. An audiogram is not a reflection of an ability to understand speech. Some of the audiograms with moderate or even mild hearing loss in the low frequencies but no hearing above 1500Hz are PERFECT CI candidates because NO cochlear implant currently stimulates the base of the cochlea where low sounds are received.
    I have to agree with other commenters that you tend to opine about audiology without the necessary education.
    "access to speech" is meaningless if the cochlea is too damaged to send intact impulses to the auditory cortex. In addition, your math is baseless. Amplifying sounds does not equate to understanding.
    And you should really do more thorough research on stem cell "cures" for hearing loss. As a scientist and stem cell researcher I feel you are giving false hope and that you have been given false hope.

    ReplyDelete