If you read my last blog, A slow time: has my auditory rehabilitation plateaued?, you’ll know that I was having to work hard to hang on to the notion that slow progress is progress still, and that I was making it. A fortnight on, and so much is happening. I’ve enjoyed a silent disco in the kitchen, with music blasting into my cochlear implant; I’ve been phoning people in my house – because now I can; and I’ve been hearing recorded voices and people on zoom with considerable success. Week 16 since switch-on feels like a watershed week.
The chief reason for the leap forward must surely be the technical adjustments made at my MAPping appointment last week – and my brain’s response to them. Cochlear implants (CIs) need to be programmed according to the needs of the user, with the aim of maximising speech perception. This is the chief reason for audiology appointments in the wake of having a CI. As I understand it, optimal current levels per implant electrode are worked out and together these are called a MAP. So, my CI was connected to a computer while Alice the audiologist made adjustments according to my responses to beeps. I was asked to indicate my level of comfort with the amplification, in a kind of Goldilocks approach – too loud, too soft or just right?
Sometimes there will be speech perception tests after making these adjustments, but there wasn’t time for this, so that will have to wait for my next appointment. However, there was an immediate improvement in speech clarity, so I was very happy about that.
Alice also added four progressive levels to my programme, gradual increase in loudness levels, with advice to work up through these (making changes via the app), sticking with one for a week or so and then moving on to the next. Going up one level after a week has brought more change and all in the right direction. With so much that’s new, this isn’t the moment to add a hearing aid for my other ear. Done now, this could jeopardise progress, as my brain might prefer latching on to what’s familiar.
A couple of days after these changes to my programme, I had another online session with Emma, the Speech and Language Therapist. Doing auditory training exercises on the Hearoes app has highlighted particular stumbling blocks for me, as has listening to my daughters, Emily and Liv, reading to me and repeating back what I hear. There are pairs of letter sounds I struggle to distinguish, such as d/g, m/n, f/s. If these continue to be problematic, the audiologist will make programme adjustments accordingly at my next MAPping appointment.
Overall, I’m noticing in conversation, on zoom or in person, I’m just a little more comfortable, a little less reliant on lip-reading or captions. I’m also hearing recorded voices with more clarity, if they are clear and not too fast.
I’m still scoring really badly on the app exercise with words where the middle vowel sound changes: hid/hood/heed/who’d/hud/had. Emma pointed out that hearing them on my phone could be making it more difficult than in person and suggested that I try it with someone saying the words (without me lip-reading). I was pleased to find that my success rate hugely improved when we tried this, though they still trip me up.
We repeated the speech tracking exercise I did in early December (which I wrote about in my blog Has it worked?” Expectations of cochlear implants and the journey from surgery to hearing) and found a modest improvement in my score, but I’m still only half way to the level needed to understand speech at a normal pace. However, I reckon a week on I’d do better if we repeated the test. I’m noticeably improving at hearing what is being read to me, live, managing longer chunks of speech and with higher accuracy. I’m also able to get the sense of it at the same time. Emma says that meaning can be lost when so much focus is having to go on just hearing the words, but I’m doing fine on that front.
Emma also suggested that I try hearing on the phone. Goodness! This needs practice and confidence. I won’t be ringing the bank any time soon, and it will be quite something if I can answer the phone without running with it as if holding a burning coal and thrusting it at someone else, all the while saying “sorry-I’m-deaf-I-can’t-hear-you-hang-on-I’m-just-taking-you-to-someone-else!”. But my first attempts have met with success. Phoning from a different room, Liv said days of the week, and colours, which I was able to repeat. Flushed with success, I have been ringing Emily and Liv to ask if they’d like a cup of tea, or how many potatoes they’d like. Today, we’ve stepped it up a bit, using the topic-based short sentences which I had in the early days for face-to-face practice. Given the topic ‘holidays’, for instance, I was able to hear Emily say “Where are you going on holiday?”; “The airports are busy in July” etc. Also, in a deviation from the script, purely for entertainment value, an unfolding story beginning with “I’m going on a lads’ holiday” and “Martin got a tattoo”! Auditory training is very boring so anything to liven it up is most welcome!
“Thank you for the music”
Well I did say there was a lot happening, and I’ve made another leap forward with hearing music. What complex auditory input this is, and there are life-long neural pathways that need to be rerouted (apologies to any hearing scientists reading this who are probably wincing at a very unscientific and possibly wildly inaccurate comment there…). Whatever the physiology of this, the bottom line is that music – and how we receive and process it – is really complex, and now my brain has to unscramble the new stimuli. Some CI users never get a great outcome as far as music goes, and I’ve decided to travel in hope but just be glad of whatever I get.
I can stream music from my phone or laptop, straight to my implant, via Bluetooth. Until this week, I hadn’t tried it for a while. I thought I’d start with the incomparable Annie Lennox. What a joy! With Annie blasting straight into my head, I couldn’t resist dancing round the kitchen, which might have baffled anyone seeing me as no-one else would hear the music.
I’ve been experimenting with a variety of music, from Brahms to Bowie, but always picking things that I know. It all sounds a bit tinny and I have a sense of parts being stripped out, missing, and I expect a hearing professional could give me a good explanation for that. But many of the melodies sound right, or at least recognisable. Some music sounds pretty good and other music pretty awful, or somehow out of reach still. Watching and listening to the first few minutes of a an orchestra playing a familiar Brahms requiem, I found I just couldn’t recognise it. The visual clues – we’re seeing the strings, now the brass – helped me to focus on those sounds. But that was specific as it got, just strings, not violin or cello. Brahms and the like will have to wait. I think there are exercises to do that may help and I will seek those out.
I’ve also listened to music walking along, from phone to implant, doing what so many people do all the time via ear buds. For me, this is a huge novelty. I haven’t done anything like it since I was at school, with earphones attached to a radio. I ask my daughters about where and how to find music online and feel like a visitor from another planet. But actually I’m a time traveller, fast-forwarding to the 2020s from the 1980s, when I was just starting to lose my hearing. I have so much to learn – and new possibilities to embrace. It all feels very positive.