Aural Rehab Activities

Because I want to improve as quickly as I can I’m making an effort to do some rehab activities on a regular basis.  And while I think my rate of improvement with the implant may be to a large extent out of my hands, doing something gives me the illusion of some control.  I think it’s actually helping too 🙂

Here are some of the aurl rehabilitation tools I’ve been working with:

  • Advanced Bionics Listening Room: Teens and Adults.    You might have to create a login but  I don’t know that you need to be an AB user to take advantage of these resources.  Give it a shot if you’re interested.There’s a lot of different practice tools here.  Among the resources availalble is a pc based program for listening practice called CLIX. I plug in with my direct connect cable to use it.  There’s a placement test and exercises at various levels depending on how you score overall.  The general format is like a word recognition test.  You hear a word and then select the “correct” word from a grid with 4 choices.  However, unlike the word recognition at the audiologist, here you can repeat it.  Usage tip: To retake the placement test, on the Main Menu click on ‘Test – On Your Own’.  It looks like a column heading but it’s not.Overall I’m doing well with this tool.  However, I seem to have plateaued and I’m stuck on the last two levels, which I guess are the most difficult.  For the life of me, I can not reliably distinguish between cake/take, taste / paste,  knees / keys,  narc/ Mark.  I’m planning to take some notes to my next appointment with the audiologist.  I don’t know if I will improve with repetition and time or if I need adjustments in my programs.
  • Med-El  – Sentence Matrix.  I like that this tool is web-based and can be used from any computer.  There are various settings you can select such as male/female voice, slow-fast speech speed, and amount of background noise (none-high).  The voice says a sentence and you click on the words, which are laid out in a matrix with multiple choices per word in the sentence.  Usage tip: Click on More in the Sentence Matrix description block from the main page to start.
  • Cochlear America Telephone listening practice.  This one is very cool I think.  You dial a phone number and are able to do several listening activities and read along on the web site for the text.  Each day there is a new word list and small passage.  So far the passage texts have been excerpts from fairy tales by the Brothers Grimm, which is fun.
  • HearCoach. A free app for iPhone.  It focuses on word recognition, with and without background noise, and number recognition.  There are multiple levels of difficulty for word recognition with high levels having increasing amounts of background noise.  I made it through a couple of levels but I’m at a point now where the background noise makes it ridiculously difficult for me and I think my score is just function of random guessing.  Hmm…  what to do, what to do.
  • Audio books.  Listen to an audio book while reading along on the hardcopy.  The recommendation is to start with a simple book, either children’s or young adult, something that’s familiar.  I’ve been trying to take advantage of the public library’s digital catalog to do this and use a kindle book plus audio book using 2 different programs on my laptop.  Finding both available simultaneously can be tricky.  My first book was Charlotte’s Web.  Now I’m working on adult fiction and mainly taking what’s available.  A friend at work loaned me the Hunger Games in both hardcopy and audio, which was my favorite so far.

Do I need a psychologist or an audiologist?

The biggest challenge for me is psychological in terms of adjusting to the implant and truly accepting my hearing loss.  I apologize if I sound repetitive when I say that part of me was hoping that I would no longer be hard of hearing once I had my implant.  No one ever told me this was a possible or achievable outcome.  I know it’s not.  But still that is my deepest, secret, not-based-in-reality wish.

I’m so tired of the effort and adjustments I need to make for each and every communication.  I have to think so much about hearing.  It’s hard for me to believe it will be easier and maybe it already is some degree easier but it’s subtle and I feel cheated.  Yes, yes, this is a spoiled bratty attitude and I know I need to be positive to do as well as I can hearing-wise.  It’s hard.

I read on support forums and blogs about the “miracles” and “wow moments”.  I’m struggling with feelings of guilt.  Why don’t I share these sentiments?  Part of it, I think, is that quite a few recipients were at a point where communication was impossible.  With an implant they rejoin the hearing world.  And this is truly a miracle.  For me, I was already part of the hearing world.  Admittedly, I was somewhat limping along and my struggles were slowly but surely getting worse.  The only choice I had for better hearing, or even stable hearing, was the cochlear implant.  Another factor may be that  some folks who are implant evangelists are speaking several years post activation. They’re at peak performance with the implant.  I’m still a beginner at 2 months out.

The biggest change I notice is the awareness of environmental sounds.  This is good.  The combination of the technology and the human brain is truly incredible.  How is it possible that this device does what it does?

My goal now is to lessen and eliminate difficulties understanding speech.  When I have difficulty hearing someone and others do not it depresses me.  What can I or should I be able to look forward to?  Am I hearing some percentage better in everyday communication situations?  How can I assess this?  Questions for an audiologist?

When I was tested a month ago my scores had tripled since activation.  The audiologist said I was doing better than average.  Do I feel three times better about my communication abilities?  It’s hard to measure in a simple way.  I’m not sure.

I want to hear punchlines

I think this probably a common phenomenon with hard of hearing people.  At least it is with me.

Oftentimes in group settings, work meetings or social,  I’ll be mostly following what someone says and then they make a funny comment or perhaps deliver the punchline of a joke.  Others in the room will laugh and I miss it.  So then what do I do?  My choices are: laugh as if I heard it, remain unaffected, ask for the comment to be repeated, assume a semi-bemused quizzical expression.  I generally try to remain open and don’t laugh because I’m done faking it.  However, it really bugs me.  And I wonder how often I’m perceived as either not having a sense of humor or just being dense.

With jokes in particular the voice cadence tends to change when the punchline is delivered and often drops in volume and is easily missed by someone like me.

I’m hoping that over time with my implant and improving hearing ability that this changes.

Because, I really do have a sense of humor and love to laugh.

Did you hear the one about a man and duck who walk into a bar…

Why isn’t my life soooo easy now? Reflections

I guess going into the cochlear implant experience I thought I’d be starting where my hearing was and just adding on some new cool features.   I think part of me hoped I’d be magically and completely “cured”.  No one told me this, ever, and I know it’s a fantasy wish.  I’m always going to be hard of hearing but, with the implant, much less so.

Let me start with an official disclaimer:

“I admit that I probably have way too high expectations of myself regarding where I should be at and what I should be able to do now that I have the implant.  It’s still early, not even 2 months post activation.  I’ve already seen a big improvement within a month, when tested.  I’ve been told that improvement will happen quite a bit in the first 6 months and can continue past that point as well.”

Before

I was down to 20% (WRS) on my left ear and 30% (WRS) on my right.  WRS = word recognition score.  I hadn’t been tested in years because as far as I knew I was still not a good candidate for hearing aids and I thought I was “too good” for a cochlear implant.  I was getting most of my speech comprehension via lip reading and contextual clues.  However, I was really, really, really good at that!  These are skills and habits that I developed over 40 years of paying close attention.  However, that kind of attention takes A LOT of energy.  And my skills were probably not nearly as accurate as I wanted to believe.

After

It’s like I’m working with a new set of parameters.  My old baseline is gone.  I think I started by trying to make an invalid comparison to before implant and after.  Hearing post-implant is a different way of hearing.  It’s been so long that I’ve missed large chunks of sound frequencies that it doesn’t seem “normal” to me.  That’s because my normal wasn’t normal.  So part of my adjustment is to redefine what my normal is and understand that comparisons to before don’t always make a lot of sense.

Today, I am hearing more sounds.  Lots of high frequency sounds and environmental sounds that I haven’t heard in a long, long time or perhaps ever.  This is cool.  It’s also an adjustment process.  Unlike a hearing people, I have to learn to disregard certain environmental and background sounds.  Right now I’m still paying attention to too much and that’s tiring.

Also, early in the CI experience I’m hearing a lot more but not always understanding a lot more.  Again, it’s part of the learning process.  I need to train my ear to recognize the new sounds I’m hearing.  One of the toughest things for me is learning to distinguish consonants.  My new high frequencies allow me to hear consonants.  Now I hear them but was that a ‘t’ or a ‘d’?  Why does the letter ‘n’ seem to disappear?  Weird and tricky stuff.

I’m doing very well as far as implant recipients go, regarding overall speech comprehension.  I have been able to understand people pretty much from the get go with minimal robotic or mickey mouse sounding voices.  This isn’t the case for everyone although all recipients I’ve met get there eventually.  As far as comprehension goes, it’s hard to say how much my lip reading skills are assisting me versus hearing things more accurately.

The journey continues…

At this point I’m noticing things seem less jarringly loud. I’m also working on aural rehab, such as books on tape and listening programs with practice exercises.

I’m curious to see what becomes easier over time.  It’s hard to self-evaluate in an objective way.  One thing I’m realizing that I need to trust my new ear more.

I’ve heard other implant users tell stories about improvement that their friends or family point out to them.  Comments like, “You know, you just heard that guy behind you.  You would not have been able to do that before.”  I’ve drawn an analogy to going to the gym.  You don’t get big muscles in one visit.  It takes time, consistent work and motivation to develop new habits.  Sigh… I mean Yes! I will do it!

How I deal with Mr. Wind

One of my very first impressions of hearing with my implant was the sensitivity of the microphone to wind noise.  Yikes!  However, I guess for many implant recipients, who have used hearing aids for a long time, wind noise is something they get used to.

graphic of cloud blowing wind

I tried bending the t-mic a bit so that it sits more in my ear canal but that didn’t seem to work.  For me, maybe due to the shape and size of my ear, the processor tends to pivot back a little and the mic doesn’t stay in the spot where I first position it.

Not to be deterred… I did a few Internet searches to see if anyone had suggestions or solutions and I found one CI user in the UK who had a friend that custom made a foam wind cover  for his t-mic.  The reason he wanted the wind cover was to deal with wind while cycling.

Next I started looking locally for small microphone wind cover or windscreen and I found that RadioShack carries a lapel microphone wind cover.  It’s a bit bulkier than I’d like but it stays on and is covered, for the most part, by my hair.

I think my audiologist may have thought I was a bit goofy, but I don’t care.  I like it and it helps 🙂

pic of Advance Bionics processor w wind cover on t-mic