Wednesday, January 16, 2008

1 Month Post Activation

A few weeks ago, on Jan 2nd, I had my 3rd mapping appointment. It wasn't really a "mapping" since we didn't adjust anything. I had gone a bit overboard on the levels at mapping #2 and had only just reached the point of running the volume at normal. My audiologist used the time to run the NRI (Neural Response Imaging), which I described in my "Mapping No. 2" post. During the NRI the software sent pulses to various electrodes in a rhythmic pattern. It sounded like wooden blocks clacking together, almost musical. I enjoyed it. She said the results were good and she would use them as a reference at my next mapping. She also removed the extra half-strength magnet from the head-piece because she felt it was grabbing on a little too strongly. It seemed to adhere fine with just the normal magnet.

Unfortunately, in the following days it became clear I wasn't quite ready for the reduced magnet strength. The head-piece would fall off too easy, just by sitting down or doing anything that slightly jarred my head. Worse, it would constantly lose the communication connection and have to re-sync -- several times per hour at least. It started to drive me nuts! My CI has a very distinctive sound when it re-syncs. First it goes instantly dead. Then, upon reconnecting after about a half second, it makes a deep, metallic, watery, reverberating "PINNNNGGGGGG" that sounds exactly like a sonar ping in an old World War II movie! Finally after another half-second the sound of the world comes rushing back. Normally it's not bothersome at all, but having it happen every 10 minutes or so I felt like I was under attack!


The following week, on Jan 8th, I had my 5 week checkup with my surgeon. He checked my scar, the site over my implant, and took a quick peek in my ear. All looked good. I told him about the head-piece. He checked it and said there would be no problem putting the additional half-strength magnet back in for awhile, as long as we keep an eye on it. It is very important to use as little magnet strength as possible. There is the potential to irritate the skin over the implant if it squeezes too tightly. If allowed to go on too long it can lead to an ulcer, which would mean not wearing the CI for the time it takes to heal, or worse it could become infected which puts the implant at risk. There have been cases in which the implant must be temporarily removed to allow an infection to clear up. He said the skin over the over the magnet toughens up with time and becomes less prone to problems.

Next we had a good little discussion about the pitch perception I have described in prior posts -- in brief, everything sounds deeper in pitch then I expect and in relation to my right ear. He was intrigued by my tests that showed about a half-octave difference the week after activation. I wondered if it had to do with insertion depth and he said it was quite likely related. He confirmed my suspicion that they have no way to precisely position the electrode array to match frequency location, adding that there is evidence pitch perception is not necessarily "hard-wired" to locations in the cochlea and that the brain may compensate over time. I think I might already be experiencing some re-wiring, since some sounds don't seem as deep as they did a month ago.

Finally we discussed my right ear hearing aid. He asked if I had been using it at all. I told him my audiologist had recommended I not use it very much during the first month or so, but that I had tried it for short periods of time on occasion. He explained that in the past they (CI surgeons) had found most users didn't want to bother with a hearing aid in the other ear because the CI sounded better by itself, or the two didn't sound good together. So they didn't encourage continued usage. But now they have made a one-eighty since there have been findings that using a hearing-aid along with a CI has several advantages if the unimplanted ear still has usable hearing. It helps with spatial location, speech discrimination, and pulling sounds from noise. And by keeping the ear functioning as much as possible it can improve the result of a future bilateral implant. I had intended to work at using my hearing-aid again, so it was great to get encouragement from my surgeon.


I like movies. Who doesn't? For the past 5 years, I have always gone to a theater with closed-captions. This severely limits one's options since there are only a couple of captioned screens locally. Once or twice during that time I went to a non-captioned theater and I couldn't understand a word. Last week my wife and I went to see "The Golden Compass" in a theater without closed-captions. Even though I've been doing really well with speech, I had no idea what to expect with a loud movie soundtrack. By the end of the endless previews my hopes were rising. Ten minutes into the movie I practically had to scrape my jaw off the floor. I was getting nearly every word, without straining. I even did some little tests switching between hearing-aid only (loud, noisy, english-as-a-foreign-language), CI only (great!), and both (slightly better!!). My best guess is that I caught about 80% of the dialog, if not more. I never felt like I missed anything crucial. The special effects and music sounded good too. Even though the movie was disappointing I was pretty thrilled.


I was in the shower the other day, cleaning my ears, and I noticed a sound when I wiggled my wet finger in my implanted ear! What? More wiggling and sure enough I heard a deep sounding flutter in my left ear. So I seem to have a little residual low frequency hearing. I will have to run some tests on that in the near future.


I have a big project going on in our little (tiny) front yard. I started it many, many months ago and had to take about 2 months off because of my medical adventures. I am finally back to work on it! It feels really good to be physically active -- and sore in the morning -- again. The sound of a shovel digging into wet decomposed granite is just lovely, "Crrrruuuuuunchhhhhh!"


As a parting gift -- ponder this number: 134861.10

4 comments:

Anonymous said...

Love the movie experience! Bad movie but great experience!

Ethan's in need a new magnet right now, he's had some redness on one side and I realized that it's a #2 and needs to be a #1 magnet.

Why am I pondering that number? Intriguing. Maybe I'll play the lotto with it.

Jennifer said...

I had to get a stronger magnet at activation and have just kept it...it hasn't bothered me yet. I didn't realize people could have such problems with the magnets...will have to remember that!
And I have NO idea what that number means...I'm not good with numbers, anyhow, and they don't do anything but confuse me! ;)

Valerie said...

It is about time for an update. I am so excited for the movie experience. I am working my way up to a movie. I hope I have the same experience. I still have some residual hearing, not much but some.

Enjoy all the new sounds and have fun.
Valerie

Abbie said...

I'm going to say that number is the cost of your cochlear implant surgery and all the parts that come along with it on your explanation of benefits :)

I remember around the 3rd and 4th mapping, things were rather uneventful. That lovely "oh boy" sound just started to dissipate and sound was beginning to sound like normal.

When I first got my magnet, I need a half a strength more to hold on my head and I have continued with it. In the beginning it was falling off pretty easy but it stays on pretty good now!

That is very interesting about the pitch perception. I tried that audio program and for the life of me, I have no idea what i'm doing with it. :) Would you mind explaining how you can tell you are half a octave difference to a blonde? :)

My audi told me to keep my hearing aid out for three month but I had it back within a month. I hear far more with my CI then I do with my hearing aid. Take this for example, with just my CI, I can hear music at a volume level of 2, with my hearing aid it is 14 and I get nowhere near the clarity that I get with the CI. With both, it is still a volume level of 2 :)

I'm going to the movies on Sunday for the first time! I'm excited!