Tag Archives: Medel cochlear implant

Cash, granola and more as a cochlear-research subject

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I don’t mind being a guinea pig. In the two-plus years since I received my cochlear implant, I have volunteered to be the subject for a variety of research into hearing and related technology.

On a hot summer’s day during the 2020 lockdown, I got a new request by email:

Good Morning Ian,

My name is Emmanuel Chan, not sure if you remember me, but I am a research assistant from the Cochlear implant lab at Sunnybrook Health Sciences Center.

I remember you well, Emmanuel, I thought. The last time we met, you used a gooey gel to attach about 50 electrodes to my scalp and made me listen to musical duets. How could I forget? I was frustrated that it was so hard to distinguish between the sound of different classical instruments playing simultaneously.

Ian with electrodes

“We are not amused”

But you had a great attitude, explained everything carefully, and at the end of the session, you gave me some shampoo to wash my hair, a granola bar, a parking pass, and twenty bucks. You were doing important work to help cochlear implant recipients. I drove away from the hospital parking lot in my minivan with a smile on my face.

Maybe this guinea pig could help other people who share my journey.

Hearing and quality of life

Emmanuel continued his latest e-message: I am emailing you to let you know about an opportunity to participate in research with us. As a reminder, our lab focuses on cochlear implant populations, investigating a variety of aspects including cognition, perception as well as quality of life.​

At the moment, we are conducting some online tests investigating speech perception and the quality of life of people living with, and without cochlear implant(s). This data in turn will be used by clinicians to optimize rehabilitation for patients with cochlear implant(s). There will be a total of 4 online questionnaires and 1 online speech test. The questionnaires and speech test should take a total of 30 minutes to complete.

Aha — optimizing rehab for patients with cochlear implants. That is one area where I could have used more help a couple of years ago. I had done homework to get used to my hearing system, using programs such as Speech Banana, but felt bewildered by all of the potential programs and technologies. I sometimes wished I had a hearing-rehab guardian angel.

Cash and granola bars

So I replied by email: “Thanks Emmanuel, I should be able to get to it this week.  Will keep you posted. In addition to the $20, I would not turn down a granola bar, like the one you gave me last time.  (:”

Emmanuel sealed the deal:

Hey, your participation is very much appreciated. And if I am around the next time you are in the clinic, feel free to stop by for a snack, haha.

Best,

Emmanuel Chan
Research Assistant
Department of Otolaryngology
Sunnybrook Health Sciences Centre

Emmanuel provided links to the online questionnaires and speech test.

I sat down with my laptop to tackle the first two questionnaires. One focused on elements of sound such as speech, environmental sounds, and qualities of hearing. The second looked at the quality of life for a person who has a cochlear implant and/or hearing aid.

I was providing answers using a sliding scale, or multiple choice, that would hopefully help the research group identify trends and issues around cochlear implant rehab. At the same time, a few of the questions got me thinking. So I decided to answer them in my own words:

You are in a group of five people, sitting around a table in a quiet place. You can see everyone. Can you follow the conversation?

This question took me back to the feeling of dread that would creep up as I walked into our small team meeting at the office a few years ago. Over time, as my hearing worsened, I began to “lose” certain colleagues who spoke softly or quickly.  When my hearing was at its worst, it took all of my energy just to focus on our director. I would sit across the table from her to ensure I got the key messages, and any take-aways. My manager was aware of the problem and would often sit next to me to help out if I missed something. The workarounds helped, but I was no longer fully part of the give-and-take discussion of the team. It felt more like survival.

Today, with new hearing technology including my cochlear device, I have more confidence in a small group. Besides just functioning, I can enjoy the people, personalities, humour, banter. Hopefully, I can engage and contribute. It’s not perfect. My hearing sometimes gets overwhelmed by too many voices, and I have to ask somebody to repeat themselves. But that’s a good problem to have compared to survival mode.

Can you tell how far away a bus or truck is, from the sound?

I’m doing better. When I walk down a country road, I can hear the vehicles approaching behind and in front of me. On a busy city street, I feel more tuned in to the sounds.

The Medel cochlear implant in my right ear is sensitive and can pick up a distant sound. The Bernafon hearing aid in my left ear has been tuned up and improves my directional hearing. My meniere’s disease — which causes inner ear fluid, balance and hearing to go haywire — has given me a break for the past year, so while the hearing in my left ear is poor, it is stable.

My directional hearing improved but sometimes plays tricks on me, so if I am walking with Nadine, she still shouts “Car!!!!” when a vehicle approaches.

I feel more confident these days that I will not accidentally throw myself under the bus, so to speak.

Can you distinguish voices on the radio? Are you able to enjoy music?

For several years, I had turned off the radio and CD player in our car.  I might try listening to the news at the top of the hour, or a song, but I would often shut off the player in frustration. The sound felt chaotic to listen to. Singer Huey Lewis, who also has meniere’s, has described how he had to stop performing after he could not reliably hear the pitch of the music.

This past summer, I realized I could listen to CBC radio for longer stretches — let’s say the news plus a current affairs show. And “get” about 75% of what I heard.  More than enough to enjoy radio again. With my new hearing technology, I sometimes even find myself feeling happy listening to the radio. With a little concentration, I could once again lock onto a familiar song.

Do you feel anxious talking to strangers?

During the covid era, masks have complicated things for people with hearing impairment. I have had some whacky situations recently in which I could not understand a word that a stranger said. But overall, my hearing tech puts me in a much better spot than a few years ago.  I don’t feel that creeping dread — or avoid discussions with strangers like I used to do. In simple one-on-one situations, like a person asking directions, or going into a bank to speak to a teller, I feel more relaxed and confident.

A friend and fellow cochlear implant recipient has been taking more assertive action during the lockdown — advocating for masks that allow us to see the person’s lips.

Read my lips — with the covid virus not going away anytime soon, it is important to look at mask options that will allow us to see your lips.

When communication is difficult, let’s be patient and kind to each other!

ian and stone

“Can you see my hearing technology?”

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And thanks Emmanuel to you and your colleagues — I hope your research goes well. The questions you are asking have made me think about the hearing journey in a new light. I will get you those completed questionnaires back this week.

I am good with my gig as a hearing-research guinea pig.

 

 

 

 

Facing the music

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As I relearned how to hear human speech through the combo of a cochlear implant and conventional hearing aid, the ability to hear music was also slowly coming back.  Especially with familiar music, my brain could bridge my memories of how music should sound, with the reality of my new sonic inputs.

hearing and music image

In speaking to some friends who had also gone through the cochlear implant (CI) journey, I knew that ability to appreciate music varied wildly.

John, a management consultant, had learned how to play piano in a new way after he received his CI, relying on sound as well as touch, intuition, kinetics and sight. John also placed more focus on rhythm and dynamics, since the ability to distinguish pitch was sometimes difficult. This reminded me of Scots percussionist Evelyn Glennie, who is deaf and uses multiple senses to perceive music and perform at an international level.

Shelly, a retiree, was starting to enjoy live classical performances again after many years of not attending due to hearing trouble. Suzanne, a health researcher, was still struggling with how bad music often sounded.

“Music is a much larger part of our life than anyone realizes, until they lose the ability to hear it,” Suzanne* told me. She switched from a direct-care role to research after her hearing loss caused increasing difficulty in communicating with patients. She had a cochlear implant (CI) several years ago.

Music language and loss

“Music is a universal language — it can affect your mood, your emotions, your overall well being,” she said. “I cannot express the enormity of losing music.”

Her cochlear implant assists with speech but listening to music can feel unbearable. Occasionally, Suzanne enjoys a music memory, replaying a song in her mind from her youth, from the time when her older sister had all the Beatles’ albums.

Neil Hockley, an Audiologist in hearing aid development at Swiss-based Bernafon, said: “the real key to music and CI/hearing aids is that while there are guidelines to help, there are no rules. So it is really important that clinicians work with their clients to find out what sounds best.”

Conveniently for me, audiologist Neil is married to my cousin Jennifer. She also works at Bernafon — a world leader in hearing technology — in its marketing department. At a family event some years ago, I noticed Neil in my peripheral vision, to my left. I turned to that side and caught him peering at my left ear. Once he had had a good look, Neil declared: “Oh sorry, I’m always curious — I worked on the program for your hearing aid!”

Thanks Neil!

Perception is personal

On the question of music, Neil believes that “perception is incredibly personal. What works for one individual might not work for another, even it their favorite instrument is the same and their hearing loss is the same.” He notes that human speech patterns fall into a more defined band, while music patterns have a wider sonic range and much greater segments of intensity.

In an interview with Live Sound, a magazine for sound engineers, Neil noted that noise reduction applications on hearing aids may help to understand speech but interfere with hearing music.

His audiology colleague in Toronto, Dr. Marshall Chasin, has worked to create special music-hearing options on hearing aids. These customize music hearing by disabling sound reduction and feedback reduction while also enhancing certain frequencies and sound directions. Dr. Chasin has spearheaded the discussion of music in the hearing aid industry. Audiologists continue to investigate how digital hearing aids can better handle the intense inputs of music.

Medel

I went online to the website of Medel, the manufacturer of my cochlear implant, and learned a few encouraging things about CIs and music:

— Young children with cochlear implants have huge potential to play and enjoy music as they learn the new hearing pattern

—  Some former musicians who regained lost hearing through a cochlear implant are now playing again, even though the sound they now hear is quite different; this is the case of my friend John, who has played piano since childhood

— It is important to actively engage with music in some way, to work at listening and/or playing, to engage with the different elements of music.

At Sunnybrook Hospital, where I received my CI surgery in 2017, I agreed to be the guinea pig in a new study in collaboration with the University of Toronto. It explores how the brain sorts out different musical sounds heard through a cochlear implant.

After researchers attached about 50 electrodes to my head, I listened to duets of two different instruments — such as guitar and a flute. My task was to focus in on one of the sounds, as they tried to map how my brain was responding. I was reasonably successful at isolating a single instrument, but I found it painful how bad the instruments sounded. With practice, would the music sound better? I came away disheartened. I could empathize with Suzanne’s comments about music feeling unbearable.

Ian with electrodes

Neil pointed me to the work of Scientist Charles Limb. Dr. Limb, who is also an ENT surgeon, has studied how the brain flexes to generate creativity in musical forms such as jazz and rap. You can find his fascinating lecture on TED Talks.

During creative musical expression, the brain’s energy is refocused. Certain parts of the brain are able to disassociate, allowing spontaneity and creativity.  Limb mentions the jazz tradition of “trading fours.” This is meaningful to me because I used to get a chance to improvise on the drums on four-bar segments while playing with Barry Cartwright’s jazz band.

Creativity in “trading fours”

Likewise, when I was a percussion student, my teacher Glenn Price and I would trade fours on two drum sets, face to face. One of us would keep a structured beat while the other improvised, then we would switch. The improvised segments involved a different mindset than keeping the beat. Improvisation required fluidity, and an ability to respond creatively to another musician’s improvised theme. Finally, trading fours fostered inspiration to create and develop a musical theme.

My thinking on how to relearn musical appreciation and performance was moving in a new direction. I had been focused on what I called a holy trinity — consisting of two quite different sonic inputs (hearing aid and CI) plus my memory. My brain blended the three.

As I learned more from friends, and experts, I felt I had to add three key factors: 1) music engagement, 2) creativity and 3) the use of multiple senses.

I was facing the music: my holy trinity of hearing had become a holy sextet.

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For more info:

Interview with Neil Hockley and Marshall Chasin in Live Sound:

http://digital.livesoundint.com/publication/?m=24712&i=548311&p=26

Dr. Marshall Chasin website: http://marshallchasinassociates.ca/

Dr. Charles Limb TedTalk:

 

*Suzanne asked to be anonymous for this article — her name is changed.