THE BEST CHRISTMAS PRESENT EVER!

 “The art of conversation is the art of hearing as well as of being heard.”

― William Hazlitt, Selected Essays, 1778-1830

 

I’ve been quiet for some time now because nothing has changed in recent years. I have sunk into a routine that suits my life and expectations. I am very comfortable with my hearing. It is not perfect, but then I have forgotten what that is, however I do very well. I am not inside my ‘shell’, I can converse in face to face conversations or even in small groups if there is not too much background noise to distract me. I have accepted the technological limitations of my Cochlear Nucleus 6 processor but would now like to advance. My progress means now I want even more progress but I am so grateful for what I have been given I will not complain. 

I have no natural hearing anymore and although I am still deaf I don’t behave deaf, as I once did. Switching off has its benefits that hearing people wish they had too. Those around me have forgotten I am deaf and so do not always give me the assistance I sometimes need to listen well.  My brain seems to be slow at times and still needs concentration to keep hearing words, which means I do drift away sometimes if it is too much trouble to keep up with the conversation. I notice I am not a casual listener, overhearing others on the bus or in the street as I pass needs me to concentrate and pay attention if I want to know what is being said (not that that is really my business) otherwise it is just noise. My brain recognises the pattern of sound as being speech and so alerts me to it as it did so often when I couldn’t hear well with hearing aids and I thought I must be missing something. I can hear words attempted in running water and sudden sounds can become name calling. My brain’s interpretation of what it thinks it might be becomes “I hear what I want to hear!” Old stuff resurfacing in a different scenario even if not as frequent as it once was.

When I was implanted in 2015, I was advised I would be upgraded in about eight years according to availability and future developments. I didn’t know at the time, and wasn’t told, that a new processor was in the pipe line. The Cochlear Nucleus 7 was just a few months away from its launch in the UK. When it came out I admit I was a bit jealous of its ability. When a friend said he was going to have a cochlear implant a few years ago, he asked me for advice. His circumstances were very similar to mine and so I suggested he choose the Cochlear System as well since I knew how it worked. He of course got the newer N7 after his surgery with all its bells and whistles. 

The policy has changed after seven and a half years following my implantation and now the equipment is distributed directly from the manufacturer as are the replacement parts and extras that can be bought. When I wanted replacements for the worn out rechargeable batteries my hospital CI Department dealt with it themselves. Now they can concentrate on just me rather than the technology apparatus and just do the tuning requirements and first time supply. Cochlear UK response time and distribution efficiency is very good.

I have needed very little adjustment in recent years but I did find I was becoming intolerant of higher pitched voices. Not what was being said but how it was been said. The overemphasis of the higher frequencies made female voices (and a few men) and in particular excitable female voices, come across as very harsh and shrill so distracting me from the actual words. High frequency sounds were the first ones to go in my early days of hearing loss and it was a surprise when I got them back. Because I can now detect the subtleties of accents and inflections in speech, which makes it far more interesting, this new development was particularly annoying. The retuning I received helped to sort it out and a new channel was introduced to aid music appreciation. I had long since given up on that but the difference was amazing.

The differences in brain interpretations of sound is especially noted in catering for the separate individual subtleties of; environmental sounds, speech, and music.

I admit I am still “phone phobic”. I have always struggled with disembodied voices coming through anonymous speakers. I do well with lip reading a real faces. It can be fun reading sub-titles and noting they are not accurately portraying what is being said. If I am familiar with the voice, like that of my family, it works better. My wife has been making my phone calls for me for years now and I prefer to use emails. The introduction of Zoom appointments with my Hospitals had a mixed and uncertain response from me. At least the wearing of masks has never been a problem.

Which brings us to last Christmas.

I received the communication that I was to receive my upgrade! To be delivered to my door, preloaded with my personal tuning, and to arrive during the week before the Christmas weekend.

I had attended a Christmas lunch as a guest with a large group of acquaintances the week before. There were eight of us seated around a large round table. As expected the conversation came crossing and mixing from all directions but only those next to me got any sensible replies. This, I knew, was my normal performance.

But in the back of my mind was the knowledge of the new Cochlear Nucleus 8. 

I had waited so long that I had jumped a whole new version to receive the latest model introduce to the UK in 2022.  Of particular interest to me was the smaller size, advanced noise cancelling and forward focus selection on the microphones for better face to face conversations in noisy environments.

Christmas Day lunch was with my extended family of nine around the table and for the first time in many, many years I could participate in a round table conversation.

But perhaps the most refreshing part is the ability to stream Bluetooth sound directly and automatically from my mobile phone. No more fuss connecting wires or remote apparatus to my processor in advance and trying to answer a call before they ring off. Trying to negotiate automatic answering systems with questions about which number to press and access services had always confounded me. You can't ask them to speak slower or repeat the last sentence. Even the answering service on my mobile phone was bad enough to prevent me trying. I had to ask my wife to do it for me.

Now I am able to listen without the background sounds around me in shops, on the bus, in the street or with the tv on. I can be like everyone else and glue myself to the phone oblivious of everyone but without the need to increase the volume and annoy those around me. I have already made calls to arrange appointments with my Doctor’s surgery and dentist all on my own! 

One of the benefits of waiting so long is that the list of mobile phones compatible with the Cochlear N8 processor has now included Android as well as iPhones. My own choice was the Google pixel 6a. By no means the only one but very capable of doing the job.

When it eventually stops raining I will go out and try my new processor more in public and explore just how much of an improvement it will be to me. 

It may even raise my expectations for the future even more.   

Will they keep up with me?

What more can they possibly offer in future developments?

LISTENING IN THE REAL WORLD

"Anyone who takes the time to attentively listen is either an old soul or a romantic one."

Richelle E. Goodrich, Slaying Dragons 

I find stage performance by true actors to be much easier to understand than the cinema or tv.
Television in particular and cinema, even though it is so loud, has a lot of mumbling and incoherent phrases these days with distracting background mood music.


So off I went happily to our local theatre to hear a 'life reflective monologue' in a small studio. I was in the second row and had asked in advance if the hearing loop was switched on. The acting style was not the usual stand-up audience facing kind so some extra help seemed a good idea.

The loop was so weak the sound kept disappearing. It was better to just listen to the amplifier. Although voice into microphone, then out of speaker into another microphone (my processor) and then into my head is never the same as the real direct thing. I heard and understood a lot from about twenty feet. Enough to be satisfied as a deaf person.


Then something strange happened! 


Towards the end the actor's voice became much clearer, I could hear every word he said even though the performance was casual, inebriated and slurred (for effect) by that time.

After the applause had died down my wife turned to me and asked if I had noticed the microphone he was using had failed and the speakers had gone silent leaving only the actor's voice in the room.

The curtained walls and soft seats produced excellent acoustics and whilst those at the back may have struggled to hear, I was enjoying the technical failure unaware. What a pity it hadn't happened earlier.

On leaving the theatre apologies were offered for the breakdown.
I assured them I had enjoyed it so much more for it.

We had a good laugh, I think he was glad to have at least one happy customer.


If only all restaurants, public buildings and meeting places could be so plush and comfortable for us.
With the speakers turned off!


Perhaps my most memorable occasion was a celebration afternoon tea at a local and popular venue.
In those days I had no ability to use the telephone and asking my wife to do it would ruin the surprise, so I booked online. I mentioned on my booking form I was profoundly deaf and would like, if possible, a quiet corner table to make conversation easier.

On arrival at this very plush and rather special place my wife and I were ushered into a side room. All to ourselves and it was carpeted, had heavy curtains and sumptuous cushioned furniture. The acoustics were incredible with none of the usual echo or harsh sounds reflected off the walls and hard surfaces. I felt quite honoured to be treated in such a special way.         All because I had asked, a speculative whim perhaps, but a lesson just the same.

"If you don't ask you don't get."

Though unfortunately that often applies when you do as well!
I have, on some rare occasions, managed to get background 'muzak' turned off (as the only customer in the place!) but just getting it turned down often needs the equivalent effort of an Act of Parliament.

HOW CAN I UP-CYCLE MY REDUNDANT OLD EARS?

“Though love may be blind, it sees much;
though it may be deaf, it hears much;
though it may be mute, it says much;
and though it may be lame, it does much.”
~  Matshona Dhliwayo ~

What do I do with my ears now they no longer work?

I can’t flap them like an elephant to keep cool or shade my eyes from the sun like a pig. To do that I would need to have 32 specialist muscles like a cat to enable me to rotate them instead of the six that I do have.

I do like the idea of storing sweets in them like a chipmunk’s mouth pouches.

So what did I use them for when I did use them properly?

First, ear anatomy: 

The auricle or pinna (the heart version is because it is ear shaped).

As opposed to: Oracle (noun); an authoritative person who divines the future or an obscure prophecy revealed by someone believed to be infallible.

The outer ear is made up of cartilage and skin. There are three different parts, the tragus, helix and the lobe.

 This is to save you looking it up on Wikipedia. 
 (Though do if you wish, it is something we just take for granted when it works properly)
  

Development

The developing auricle is first noticeable around the sixth week of gestation in humans, developing from auricular hillocks which form the folds of the auricle.

Function

The auricle's functions are to collect sound and direct it. It does this like a funnel, amplifying it and directing it into the auditory canal. The filtering effect preferentially selects sounds in the same frequency range as human speech. 

Something that Cochlear Implant processors try to do.

Amplification

Amplification of sound by the pinna, tympanic membrane and middle ear causes an increase in level of about 10 to 15 dB which is an important factor when loud sounds cause inner ear trauma.

Notch of pinna

The pinna design eliminates a small part of the frequency range and works differently for low and high frequency sounds. For low frequencies it is similar to a reflector dish. For high frequencies it is more sophisticated. Some of the sounds that enter the ear travel directly to the canal while others reflect off the contours of the pinna first. These enter the ear canal after a slight delay. The delay is directionally dependent, affecting sounds coming from above more than those coming from straight ahead. This aids in vertical sound location in combination with the sideways directional function of having two ears, thereby providing a three dimentional signal that the brain can interpret.

I now, unfortunately, have no directional sound location of any sort as I have only one functioning inner ear. A similar effect to having only one eye and not being able to see perspective.

To make up for it deaf people use their increased awareness in other senses and look for clues visually. This often results in a delay to respond while they sort it out.  Hearing from behind is always a problem and explains why so many deaf people do not respond to questions from that direction.

They are not aloof or ignoring you, they simply don’t know it’s you or where you are. 

Be patient

Start with recognition and attention

Use face to face as much as possible 

Two implants would help but they are not routinely available for adults in the UK. Newer CI processors have a dedicated backward/forward microphone function. This needs to be selected when wanted but like other hearing channels programmed into the processor, with a remote control to help, it adds to the growing sophistication of micro electronics available to deaf people. Hearing aids for hard-of-hearing people who do not qualify for Cochlear Implants are now employing this advanced technology too.

In children bilateral implants are usual as it helps them with many aspects of mental development, giving as near normal an environment as possible for learning.

Hybrid solutions utilising implants paired with a hearing aid on the other side are available for those not completely deaf or with uneven severe hearing loss. Voices may not be understood with the hearing aid but traffic noise or general sound awareness can be very useful for telling where it is coming from.

 

For me, I am beyond all other help,

so the chipmunk solution is looking very appealing!