In the first week after my cochlear implant (CI) was switched on, and which began with everything sounding like beeps (as I described in my blog After cochlear implant switch-on: it’s beeping awful!), I have sung a duet with a robot. This little robot – let’s call it Robbie – is the voice I hear in place of all noises, including speech. Robbie also seems to be hung about with a set of windchimes, which clank away some of the time, presumably in response to noise. But here’s the amazing thing: while most sounds still seem the same to me, I can now understand speech! It’s Robbie’s speech, and there are many limits to my comprehension, but there it is.
Before I explain, more about that duet. Two days after switch-on, with no-one around to hear whatever noise I might be making, I sang the first song that came into my head – Daisy Bell, popular when my great-grandparents were going to London music halls to be entertained, back in the late 19th century! It’s a simple tune and I’ve known it from infancy. I could hear my own voice with the tune and, above it, Robbie with his one-note mechanical voice. Weird. But I rather liked it! It needed new words though:
Sarah, Sarah, give me your answer, do!
What can you hear with a CI that’s new?
Everything sounds robotic,
It’s making me neurotic,
But I will train my auditory brain ‘til I’m hearing as much as you!
Looking up the history of this song, I discovered the pleasing coincidence that this is the earliest song sung using computer speech synthesis (in 1961) – how about that?!
Learning to hear with a CI
This seems to boil down to three things.
This is done by an audiologist. I have six appointments for this over a year, with my first tomorrow.
This involves working at hearing exercises, mostly on my own, but I have eight sessions with a speech and language therapist in the first year.
I’m doing about an hour a day, working on hearing exercises online. Most of these are on the Hearing Success programme provided by Advanced Bionics (with Phonak), makers of my implant. Margaret, Kylie, Vic, Jay, Sam and Angela are the new people in my life. They speak sentences for me to try to recognise and read aloud paragraphs I listen to whilst reading the words too. There’s a variety of listening exercises and options to do them with the video on (to enable lip-reading) or off and to add background noise (I won’t be doing that yet!).
A harsh reality of auditory training, for me anyway, is that it’s both boring and difficult! But I am relieved to find that I am seeing some progress. I am often getting full marks for hearing accuracy when lip-reading too, and my success rate is improving when not lip-reading but selecting from a list of words or sentences. I am not understanding more than the odd word with neither lip-reading nor written clues, but I have to remember that this is how it would have been for me with my two hearing aids, where I was highly dependent on lip-reading.
Robbie is ever-present. All voices sound exactly the same, on that one robotic note, yet I find some speakers easier to understand than others. Differences between them are apparent, though, when seeing their mouths.
Using the CI alone (without a hearing aid in my other ear)
Initially, this needs to be done for as much time as possible, to help the brain adjust. I’m not sure how long this will be advisable for. Further down the line, I’ll get a new hearing aid that is compatible with my CI.
I have been using the CI only most of the time, each day. I’ve added the hearing aid when I’ve really needed to hear speech – in shops, for zoom calls, and for some conversation at home, though I’m doing well at hearing my family using the CI, as long as I can lipread too.
I’m also keeping an eye on my Sound Bingo sheet, which lists everyday sounds to check off when I can hear and recognise them. Not much progress there, but I can hear and recognise a few sounds: perfume spraying, cutlery going into a drawer, knocking on a table.
What about the kit (and caboodle)?
The basic kit seems to be straightforward. At night, I take off the external parts (the behind-the-ear processor, the cable and the transmitter – attached to each other) and put them in the drying box. The battery comes away from the processor and joins the two spares on a docking station to charge overnight.
More challenging is getting to grips with how this works with other things. I need to learn about streaming to my implant via Bluetooth and how it works with accessories like the Roger Pen. I also need to do my homework on the two accessories that are offered as options with to new CI recipients; I get to choose one for free. There is excellent support on all this from Advanced Bionics (AB). I’ve had a zoom call with Shahad from AB, who was really helpful. As well as talking about the tech, she also solved the problem of my CI cable sticking out from my head like a teapot handle!
The need for honest conversations
All in all, I’m fairly pleased with my progress in these early days. But it is all stranger and harder than I thought it would be, and this week has given rise to some reflections.
As someone who was only just eligible for an implant, so hearing more than most CI candidtates, I have had to lose before I gain. That is, hearing is harder for me at the moment than it was with two aids.
I know I am in a fortunate situation, and I can do a great deal to help myself learn to hear with the CI. But I’ve been thinking about how difficult it must be to give time to doing the auditory training exercises, and to use the CI exclusively, for someone with dependents to care for, or a public-facing job, or working in a noisy environment. It would be harder too for someone without access to a computer or other digital device, or who finds such things difficult to use.
Lastly, it is so important not to downplay the impact of having a CI and how much time and effort it takes to get to those longed-for hearing outcomes. I have read and heard quite a lot about the surgery and about what the eventual benefits are likely to be, but not so much about the bit in between. In my experience, hearing professionals are very willing to answer any questions about it, but how do potential CI recipients know quite what to ask? I’d like there to be honest conversations that spell out what this path involves and to see more information circulating that balances out the ‘miracle of hearing with new CI’ videos. I hope that this blog can make a small contribution to that.
In case you’re wondering, am I sorry I’ve gone for this? In the words of Edith Piaf, “Non, je ne regrette rien”!
Absolutely wonderful blog my friend. Asking the right questions. And so well written
Thanks so much Brian!