CI: 2 days out - How is my hearing now?

Okay. I’ve described the path to this point. So just how is my hearing now?

My left ear is worse than my right, as it has been since things started going downhill. So my left ear will get the implant.

In audiological lingo, my left ear has a hearing threshold that slightly declines across the frequency spectrum, ranging from 90 dB (Decibels SPL) in the low frequencies to 100 dB in the highs. My right ear is flatter, about 75 dB loss across the board except for a dip to 85 dB centered around 2 kHz. My hearing aids can lower that threshold by about 50 dB, but that no longer helps as much as one would think (more on that later). My speech recognition scores are 0% left, 20% right, unaided. And not a whole lot better aided.

A normal ear has a threshold in the 0 to 20 dB range. Speech sounds generally are about 20 to 50 dB. A vacuum cleaner is about 60 dB, a barking dog 70 dB, a piano 80 dB. Motorcycles and lawnmowers are 90 to 100 dB. Concerts, jet planes, jackhammers, guns can be 120 dB and higher.

This is known as sensorineural hearing loss (SNHL). Meaning that it is an inner ear problem. Nothing is wrong with the mechanical parts in the outer and middle ear. Most likely many of the little hair cells in the cochlea have died off and/or been blown away. Why that has happened is probably due to some genetic anomaly. My older brother has a similar condition, but it isn’t as bad. He still functions well with hearing aids. There is no known history of it in our family, which could mean there is a recessive gene involved.

A companion condition to SNHL is known as Recruitment, which has increased as my hearing has decreased. Recruitment causes both an increased sensitivity to loud sounds and frequency distortion.

Without my hearing aids, the world is pretty quiet. On the plus side, barking dogs and traffic noise don’t affect my sleep. The majority of sounds are below my threshold. Low frequencies tend to be more powerful so come through the easiest. If I walk through my wooden floored house I can hear the thump of my footsteps, but not the clack. If someone is talking close by I catch the mumble of vowels. Louder sounds, like clattering dishes, a loud motorcycle or concert, are painfully loud and distorted. The best way I can describe the distortion is the sound of an overdriven speaker. It smears the frequencies.

When wearing my hearing aids, I hear most sounds at a perceived loudness that isn’t much different than years ago. What seems to be disintegrating is clarity, which I assume is due to the frequency smearing “feature” of recruitment. I hear people talking just fine, but it sounds indistinct, mushy. At its worst, in a group setting, it’s very much like listening to a foreign language: the sounds don't assemble into words or meaning. At best, in a one-on-one conversation in a quiet environ, with someone who has a distinct voice, the remaining hearing in my right ear is able to just grab enough cues to perceive enough words to follow along. Most of the time I’m constantly guessing, using a combination of lip-reading and context. And of course I often use the old standbys, “Can you please repeat that?” or “what?” or “huh?” The most interesting conversations and monologues tend to be unpredictable, and as such are the hardest for me to take part in or follow. That is probably the number one thing I hate about my hearing loss.

Last and maybe least – what’s that sound in my head? Tinnitus is another lovely byproduct of SNHL. I have a quiet symphony of tones humming in both ears. If I concentrate I can perceive dozens of them in various frequencies, from low to very high. Most have the quality of tuning-fork purity. My left ear also has an array of clicks and tinks that follow bizarre random patterns. For the most part they are all subtle and not very bothersome. Rarely, I’ll get a quite loud explosion of sound followed by a roaring that subsides over the course of a few hours or days. The roar is like an intense suite of tuning-forks, a dissonant chord. In the aftermath of these events I nearly always sense another small decline in my hearing.

Well, that ends today’s lesson! I have my pre-op visit with the surgeon in a couple of hours, so need to have some lunch and then hit the road.