6 months and still not done

Visited the audiologist for my 6 month check in / tune up.  Still struggle with getting upset when I get tested with the dreaded word recognition test.  Will I ever get used to this????  Each time, the poor audiologist gets an earful of whiny, teary, adult temper tantrum complaints.  God!  It’s so embarassing.  She tries to reassure me that I’m not worst one she’s seen.  Hmm… some small comfort I guess.

Bottom line is the device is working well.  My test scores have improved again. I’m not a superstar but I’m better than average.  My latest WRS is 74%.  Considering that I started at 20% that’s obviously a big gain.  And so, the audiologist is baffled that I don’t feel like I’m doing that much better.  Frankly, I’m baffled too.

Don’t get me wrong.  I am hearing a lot more, especially environmental sounds.  And I do like this.  However, what tends to stick out for me are my trouble spots.  The typical complaints of CI users regarding the challenges of speech discrimination within background noise, especially competing conversations.   For example, certain soft voices, hearing people in larger meetings, group social situations, background noise.  I understand that this is very common for CI users.  Disappointingly, the most troublesome situations pre-implant are still troublesome for me.  And here’s the baffling part, sometimes it even feels more so?

Since I’m in a science and technology research environment, at MIT, I am curious to research possible explanations outside of my crazy brain, either physiological or technical that may explain some of my qualitative experience.   I want to learn more about how my hearing and CI work.  How they sometimes work together and sometimes are seemingly at odds.  My left ear now has 100% electrical hearing via  the cochlear implant and my right ear still has some usable natural hearing with no hearing aid.  Last time my right ear was tested it was at approximately 30%.

In my limited research so far, I stumbled upon a scholarly article that explained in-depth the workings of the CI, including science, technology,  surgical and user experience issues.  While there were parts that were beyond my understanding, much of it was very interesting and accessible to the non-engineer/scientist.  Amazing and fascinating, what an accomplishment.  As the paper says, the cochlear implant is “the most successful neural prosthesis” and “the over-arching goal of a cochlear implant is to use electric stimulation safely to provide or restore functional hearing.”  Note that this says functional hearing, not normal, not perfect.  And I can tell you from direct experience it is definitely functional.  Why am I so incredibly demanding!

The paper also touched on the fact that natural hearing still far outpaces CI hearing especially in terms of background noise.  It suggests that binaural low frequency hearing can be  helpful in discrimination ability.

My Hypotheses

For why the hearing in noise is impacting me the way it is.

  • I did not use hearing aids, which have similar challenges in noise.  Many CI users exclaim how much better it is than a hearing aid.  And, hearing aid users face similar challenges as CI users do with hearing in noise.  Had I used hearing aids previously, the transition to a CI might not seem so challenging in noisy situations and would feel, overall, like a big improvement.
  • Prior to my implant, I had some lower frequency residual hearing in both of my ears.  I could still hear speech and heavily relied on lip reading.  While my overall hearing was perhaps minimal, the binaural ability I had may have assisted me with discrimination in noise.  The loss of residual hearing in my left ear, could feel like a set back in terms of coping in noise.
  • It’s just a matter of time.  Eventually I will do better.

Thanks for reading!