Id like to learn more about CIs, have some ?s

[deafdude1]

Hello, I have been reading alot about CIs lately as I am curious to know everything about them. I am not planning on getting one this year and probably not so soon unless my hearing suddenly gets alot worse. But the more I know, the more prepared I can be and also I can offer my friends advice.

1. Is it true CIs have a dynamic range of only 10db and what exactly does that mean?

2. Do people get a CI so they can hear sounds at a louder level and hear sounds too faint to hear with HAs? What if someone is already hearing 40db or better aided, how will CIs help in that regard since the case studies I read show 40db being the average treshold of audability. Thus 40db is the most faint sound one could just barely hear.

3. Is anyone waiting for new CI technologies such as totally implantable(including reciever) laser/fiber optics, 128 electron sensors, etc?

4. How does one decide if CI is right for him or her, how much benefit would be a target? 5db louder? 10db? 15db?

5. What should those with "only" a moderate loss at 250Hz but a profound loss at 1KHz and a total loss above that do? Would they even be a candidate with so much residual low frequency hearing and would they trade most of their low frequency hearing to hear high frequency sounds?

6. As for speech perception, how does CI appear to improve this for so many people, including the posters on this forum? Is it just a matter of training and is my audiologist correct in saying I just need to train my ears more with HAs?

7. If someone ends up with a CI aided score of 50-60db range, how will they understand speech if it's not loud enough since they are at the bottom of the speech banana?

8. Shouldn't someone's unaided hearing be so poor that losing the rest of your natural hearing be of little concern? Are those who worry and hope they keep their residual hearing poor candidates since they probably can't go back to HAs if CI is worse?

9. If someone is deemed a candidate, what would the minimum odds be that CI is noticably better than HAs? 75%? 90%?

10. Is it true that CIs have only 75% satisfaction rate and there are that many who are unhappy or find their hearing worse off after CI?

11. Is any of you waiting for even better HAs rather than get CI?

12. If someone suffers from recruitment with HAs, would they experience something similar with CI where sounds are "too loud" and the volume has to be turned down then they can barely hear/understand normal speech?

13. How much of a factor is the risks and cost? Do any of you stay with HAs because of risk and cost?

14. Is it true you can't hear below 250Hz with a CI since they can't insert the electrodes deep enough into your cochlea? Why can't they give people hearing above 6-8KHz? The entrance of the cochlea is capable of 16-20KHz!

 

[Hear Again]

1. Is it true CIs have a dynamic range of only 10db and what exactly does that mean?

Dynamic range refers to the difference between the softest sound you can hear and the loudest sound you can hear.

2. Do people get a CI so they can hear sounds at a louder level and hear sounds too faint to hear with HAs? What if someone is already hearing 40db or better aided, how will CIs help in that regard since the case studies I read show 40db being the average treshold of audability. Thus 40db is the most faint sound one could just barely hear.

CIs do not amplify sound. However, when my initial CI was activated, one of the first things I noticed was how LOUD the world was. I was hearing at 60 dB with hearing aids up to 1000 Hz (NR), so I can't answer your question about hearing at 40 dB aided. My guess would be that since hearing aids are designed to amplify sounds, this might explain why some people are unable to understand speech due to distortion. CIs bypass the middle ear and thus provide clarity.

3. Is anyone waiting for new CI technologies such as totally implantable(including reciever) laser/fiber optics, 128 electron sensors, etc?

Not me. As a CI user I know likes to say, "The time to hear is now."

4. How does one decide if CI is right for him or her, how much benefit would be a target? 5db louder? 10db? 15db?

If someone can only understand 40% or less of speech in the best aided conditions, then a CI may be the right option for them. Since CIs do not amplify sound, your question about how much louder a person could hear cannot be answered.

5. What should those with "only" a moderate loss at 250Hz but a profound loss at 1KHz and a total loss above that do? Would they even be a candidate with so much residual low frequency hearing and would they trade most of their low frequency hearing to hear high frequency sounds?

A person with a moderate loss would not qualify for a CI given the fact that they have too much residual hearing. Chances are likely that they are able to understand speech at 50% or better with hearing aids. As far as low frequency hearing is concerned, I know some CI users who had excellent low frequency hearing (normal in one case), but who opted for CI due to the fact that their hearing in the middle and high frequencies was severe-profound or profound.

6. As for speech perception, how does CI appear to improve this for so many people, including the posters on this forum? Is it just a matter of training and is my audiologist correct in saying I just need to train my ears more with HAs?

When it comes to CI, yes, training is key. At the same time, there are limits as to what a CI (or hearing aid) can do for a person. I've always been an auditory learner yet despite my efforts in using my residual hearing to the max (i.e. by using a Comtek FM system with DAI connected to my Oticon DigiFocus II super power BTEs), I still could not understand more than 8% of speech in the best aided conditions with my left ear and 22% with my right.

7. If someone ends up with a CI aided score of 50-60db range, how will they understand speech if it's not loud enough since they are at the bottom of the speech banana?

CIs do not amplify sound. Therefore, it isn't a matter of speech being "loud enough." If a person hears speech at 50-60 dB, it's a matter of clarity, not loudness.

8. Shouldn't someone's unaided hearing be so poor that losing the rest of your natural hearing be of little concern? Are those who worry and hope they keep their residual hearing poor candidates since they probably can't go back to HAs if CI is worse?

This is determined on a case-by-case basis. I can't speak for anyone else as to whether or not a CI is right for them or whether or not they would be considered a good or bad CI candidate.

9. If someone is deemed a candidate, what would the minimum odds be that CI is noticably better than HAs? 75%? 90%?

According to research studies, 95%.

10. Is it true that CIs have only 75% satisfaction rate and there are that many who are unhappy or find their hearing worse off after CI?

No. Research indicates that the overall satisfaction of CIs is 95%.

11. Is any of you waiting for even better HAs rather than get CI?

12. If someone suffers from recruitment with HAs, would they experience something similar with CI where sounds are "too loud" and the volume has to be turned down then they can barely hear/understand normal speech?

It depends on the person. I'm experiencing recruitment and dizziness right now. 6 electrodes on each CI have been turned off. All frequencies have been turned down several notches as well, but I'm still experiencing problems with both symptoms.

13. How much of a factor is the risks and cost? Do any of you stay with HAs because of risk and cost?

For me, the benefits of CI outweighed the risk.

14. Is it true you can't hear below 250Hz with a CI since they can't insert the electrodes deep enough into your cochlea? Why can't they give people hearing above 6-8KHz? The entrance of the cochlea is capable of 16-20KHz!

No one with normal hearing, hearing aids or CI can hear below 250 Hz. That's why audiologists don't test below that frequency. What's the point of being able to hear above 6-8 KHz when the frequency range from 250 Hz-8 KHz is enough to understand speech?

.

 

[jackiesolorzano]

Hi deaf dude
First CI can be very a great tool for learning oral language but it is very personal decision. It is not for everyone.

Hello, I have been reading alot about CIs lately as I am curious to know everything about them. I am not planning on getting one this year and probably not so soon unless my hearing suddenly gets alot worse. But the more I know, the more prepared I can be and also I can offer my friends advice.

1. Is it true CIs have a dynamic range of only 10db and what exactly does that mean?

Each person with an implant has their own personal map and in all of the maps that I have seen I have never seen a dynamic range of 10db.

2. Do people get a CI so they can hear sounds at a louder level and hear sounds too faint to hear with HAs? What if someone is already hearing 40db or better aided, how will CIs help in that regard since the case studies I read show 40db being the average treshold of audability. Thus 40db is the most faint sound one could just barely hear.

You get an implant to hear more clearer not louder. If someone can hear at 40db and it is across all of the speech range and what they hear is clear then I think they probable do not need a CI.


3. Is anyone waiting for new CI technologies such as totally implantable(including reciever) laser/fiber optics, 128 electron sensors, etc?

If you want a CI, I would not wait. My son has a cochlear americas N22 implant and he was implanted 12 years ago, my son is still able to benefit from the lastest technology, over the summer he received the freedom processor, this has been great for him. He can now hear what the annoucers say on the car radio with all the background noise going on, which he was not able to do with 3G processor.

4. How does one decide if CI is right for him or her, how much benefit would be a target? 5db louder? 10db? 15db?

The goal of the implant is to make speech more clearer and so they would program your implant to hear at the top of the speech banana.


5. What should those with "only" a moderate loss at 250Hz but a profound loss at 1KHz and a total loss above that do? Would they even be a candidate with so much residual low frequency hearing and would they trade most of their low frequency hearing to hear high frequency sounds?

Yes, they would be a candidate because they have a difficult time hearing speech in the mid and high frequecy. This does not mean they have to get a CI but if they want to hear a wider range of speech sounds then an implant will help them.


6. As for speech perception, how does CI appear to improve this for so many people, including the posters on this forum? Is it just a matter of training and is my audiologist correct in saying I just need to train my ears more with HAs?

It does take training but more then that you have to really want it and believe in the benefits of a CI.

7. If someone ends up with a CI aided score of 50-60db range, how will they understand speech if it's not loud enough since they are at the bottom of the speech banana?

They will not end up with aided score between 50 and 60 db. The average range is 20 to 35 db. The thing about a CI is once it is program, the person will be able to hear sounds at a much wider range. The problem is if these sounds they hear become meaningful to that person and so many factors go into this.

8. Shouldn't someone's unaided hearing be so poor that losing the rest of your natural hearing be of little concern? Are those who worry and hope they keep their residual hearing poor candidates since they probably can't go back to HAs if CI is worse?

Actually now a days you are not losing your natural hearing in about 1/2 cases. My daughter was implanted 9 years ago and she has all of her natural hearing which wasn't helping her that much anyway. If someone is hearing below 95db in all frequencies, their natural hearing is not helping them hear speech sounds and if that is what their goals is then they should think about a CI.

9. If someone is deemed a candidate, what would the minimum odds be that CI is noticably better than HAs? 75%? 90%?

It depends on what their hearing was before a CI, what their hearing aide was able to do for them, and how clear they hear with their HA.


10. Is it true that CIs have only 75% satisfaction rate and there are that many who are unhappy or find their hearing worse off after CI?

It really depends on the person you speak too. I am sure you will find a lower satisfaction rate or a higher rate depending on who you talk too. There are many factors involved. It can be a valuable tool if used correctly and if the person has the right support and expectations.


11. Is any of you waiting for even better HAs rather than get CI?

There is a new hearing aide called Sumo by Oticon, but it still cannot do what a CI can do for people with profound hearing losses.

12. If someone suffers from recruitment with HAs, would they experience something similar with CI where sounds are "too loud" and the volume has to be turned down then they can barely hear/understand normal speech?

A CI is program differently for each person so I know some people that after getting a CI do not have to deal with recruitment part of it.


13. How much of a factor is the risks and cost? Do any of you stay with HAs because of risk and cost?

The biggest risk is being put under. Surgery is now under 2 hours. And if someone does not have medical insurance and really wants a CI, there are different ways of getting funding.

14. Is it true you can't hear below 250Hz with a CI since they can't insert the electrodes deep enough into your cochlea? Why can't they give people hearing above 6-8KHz? The entrance of the cochlea is capable of 16-20KHz!

The goal of a CI is to hear speech and they program so that you can hear most speech sounds.

A CI is a very personal choice. As I said it can be when used correctly a valuable tool. My son has had his CI for 13 years and it has been amazing for him. He is able to talk and listen on the phone. He can hear everything being said on the radio. He understands and uses abstract language. He does amazingly well on standardized test. He just got his PSAT scores and scored better then 85% of children in his same grade. I am not saying that a CI is for everyone or that all deaf children should be implanted. It is a very personal choice and when the child is young it a decision that parents need to make well informed.

 

[deafdude1]

I wanted to thank both of you for the answers. May I ask additional questions(or comments) based on the answers? Hear again, see below:

1. Your answer: "Dynamic range refers to the difference between the softest sound you can hear and the loudest sound you can hear."
My question: If CI isn't about amplification, can you further elaborate on this?

2. Your answer: "Not me. As a CI user I know likes to say, "The time to hear is now."
My question: I guess it's those with more residual hearing than you had who aren't in such a hurry. Better CI technology will make a bigger difference vs. what they still hear with HAs.

3. Your answer: "If someone can only understand 40% or less of speech in the best aided conditions, then a CI may be the right option for them."
My question: What if the better ear understands over 40% but the worse ear less than 40%? Also what if even if the better ear was less than 40% but that person has enough residual hearing that if he got speech training, it would improve with HAs? This is why I feel you can't go by speech % alone and one should factor in residual hearing.

4. Your answer: "A person with a moderate loss would not qualify for a CI given the fact that they have too much residual hearing."
My question: This is exactly the point ive made when I let them know their hearing isn't bad enough.

5. Your answer: "CIs do not amplify sound. Therefore, it isn't a matter of speech being "loud enough." If a person hears speech at 50-60 dB, it's a matter of clarity, not loudness."
My question: So if I understand, once a sound meets the treshold, it can be heard/understood easily, right? What about the upper half(or more) of the speech banana that is below treshold, wouldn't this still cause problems?

6. Your answer: "No. Research indicates that the overall satisfaction of CIs is 95%."
My question: Howcome I see alot of people throwing out the 75% satisfaction figures? Maybe it could be based on just the few friends that person knows? But would I stand correct that the worse your residual hearing and speech is, the better your odds of being happy with CI? If so, wouldn't it make sense to first implant the best candidates with the worst hearing then as CI technology improves, others will become candidates? There is still so many with profound hearing waiting for a CI!

7. Your answer: "No one with normal hearing, hearing aids or CI can hear below 250 Hz."
My question: Howcome websites say a normal person can hear frequencies as low as 20Hz? How do you explain I can hear the lowest piano key(27.5Hz) with and without HAs? Also my audiogram shows a 65db loss at 125Hz

8. Your answer: "What's the point of being able to hear above 6-8 KHz when the frequency range from 250 Hz-8 KHz is enough to understand speech?"
My question: I heard that high frequencies is important for music. I don't care much for music but ive been told thats because music sounds too dull and muddy for me since I only hear low frequencies. I don't even have a good idea what frequencies above 2000Hz sound like but many people, including you say it's annoying. As for frequencies below 250Hz, lots of environmental sounds and bass music encomposes the under 250Hz range.

 

[deafdude1]

Jackie, thanks for your answers too. I have questions/comments in response to your answers.

1. Your answer: "Each person with an implant has their own personal map and in all of the maps that I have seen I have never seen a dynamic range of 10db."
My question: Then explain more about dynamic range and how many db does it span? Is it less or more than 10db?

2. Your answer: "You get an implant to hear more clearer not louder."
My question: Do you lose the ability to tell how loud a sound is with CI? Also do you miss out on hearing any sounds below your CI treshold? Regarding loudness, doesn't this let you hear faint, low db sounds, such as someone whispering or the rustling of leaves.

3. Your answer: "If you want a CI, I would not wait."
My question: Wouldn't this depend on how bad someone's hearing is and how much patience they have for better CI technology?

4. Your answer: "The goal of the implant is to make speech more clearer and so they would program your implant to hear at the top of the speech banana."
My question: Then howcome from the audiograms and case studies I read about, the average appears to be 40db treshold? Is it a hardware limitation, a limitation of your cochlea or bad programming?

5. Your answer: "Actually now a days you are not losing your natural hearing in about 1/2 cases. My daughter was implanted 9 years ago and she has all of her natural hearing which wasn't helping her that much anyway."
My question: This is good news to me and everyone else! It makes CI less risky and offers a plan B: going back to your hearing aid(s) in case CI doesn't work or you aren't satisfied. This also could let a person alternate between their HAs and CI and get the best of both worlds as youd hear differently with each. Plus keeping most/all your natural hearing could leave the option for a cure open or make it easier to achieve. In those 50% of cases, do you still lose some, but not all your residual hearing?

6. Your answer: "I am sure you will find a lower satisfaction rate or a higher rate depending on who you talk too."
My question: This is why everyone should research and ask the questions I ask. They should look at the facts objectivately and calculate the probabilities based on their hearing, speech and expectations.

7. Your answer: "There is a new hearing aide called Sumo by Oticon, but it still cannot do what a CI can do for people with profound hearing losses."
My question: My audie thinks the Phonak Naida V UP is the best. He thought I should get a CI but retracted that statement. Does this mean if the loss is not *too* profound(doesn't exceed 100db), you should wait for CI technology to mature more?

8. Your answer: "The goal of a CI is to hear speech and they program so that you can hear most speech sounds.."
My question: Could that person switch/select programs for music or environmental sounds? Is better speech understanding the only real reason to get CI? I always thought it was to simply hear louder/better for all sounds?

 

[Phi4Sius]

8. Shouldn't someone's unaided hearing be so poor that losing the rest of your natural hearing be of little concern? Are those who worry and hope they keep their residual hearing poor candidates since they probably can't go back to HAs if CI is worse?

Actually now a days you are not losing your natural hearing in about 1/2 cases. My daughter was implanted 9 years ago and she has all of her natural hearing which wasn't helping her that much anyway. If someone is hearing below 95db in all frequencies, their natural hearing is not helping them hear speech sounds and if that is what their goals is then they should think about a CI.

Jackie,

This is awesome that your daughter still has her natural hearing. You say 1/2 cases. Do you mean 1 for every two cases, half of those implanted with CIs, or the odds of "2 to 1"?

 

[Hear Again]

A CI does not make sounds louder. It makes speech and environmental sounds clearer.

As for why someone only hears at 40 dB with a CI (which really isn't bad considering that others hear at 20-30 dB), there are many reasons for this: length of deafness, time of language aquisition, degree of residual hearing prior to implantation and auditory memory to name a few.

 

[Hear Again]

I wanted to thank both of you for the answers. May I ask additional questions(or comments) based on the answers? Hear again, see below:

1. Your answer: "Dynamic range refers to the difference between the softest sound you can hear and the loudest sound you can hear."
My question: If CI isn't about amplification, can you further elaborate on this?

A CI bypasses the middle ear by stimulating the auditory nerve. There is nothing to amplify since the eardrum isn't being used nor any part of the middle ear including cillia.

2. Your answer: "Not me. As a CI user I know likes to say, "The time to hear is now."
My question: I guess it's those with more residual hearing than you had who aren't in such a hurry. Better CI technology will make a bigger difference vs. what they still hear with HAs.

This varies from person to person. I cannot make a judgement one way or another in regards to someone who has a moderate hearing loss. If they wish to opt for CI, that is their decision although they will most likely be turned down as a candidate unless their loss is moderately-severe to profound with 40% or less speech discrimination.

3. Your answer: "If someone can only understand 40% or less of speech in the best aided conditions, then a CI may be the right option for them."
My question: What if the better ear understands over 40% but the worse ear less than 40%? Also what if even if the better ear was less than 40% but that person has enough residual hearing that if he got speech training, it would improve with HAs? This is why I feel you can't go by speech % alone and one should factor in residual hearing.

If the better ear understands more than 40% of speech, a person would not be considered a CI candidate. As far as AVT training is concerned, the effectiveness of auditory training varies from person to person. Not everyone can improve their hearing through AVT. There are alot of factors that determine how well someone is able to use their residual hearing -- it's not just a matter of how much hearing they have. Residual hearing *is* taken into account when determining who is a CI candidate and who isn't. My CI center, for example, won't consider those with moderate hearing loss (50 dB) as CI candidates.

4. Your answer: "A person with a moderate loss would not qualify for a CI given the fact that they have too much residual hearing."
My question: This is exactly the point ive made when I let them know their hearing isn't bad enough.

This is for the experts at a CI center to determine.

5. Your answer: "CIs do not amplify sound. Therefore, it isn't a matter of speech being "loud enough." If a person hears speech at 50-60 dB, it's a matter of clarity, not loudness."
My question: So if I understand, once a sound meets the treshold, it can be heard/understood easily, right? What about the upper half(or more) of the speech banana that is below treshold, wouldn't this still cause problems?

It depends. If someone receives a CI, but hasn't been able to make alot of use of their residual hearing (or had very little to begin with), this would acount for their inability to understand speech. A poor map could also be to blame. As for your second question, I'm afraid I don't understand what you are asking.

6. Your answer: "No. Research indicates that the overall satisfaction of CIs is 95%."
My question: Howcome I see alot of people throwing out the 75% satisfaction figures? Maybe it could be based on just the few friends that person knows? But would I stand correct that the worse your residual hearing and speech is, the better your odds of being happy with CI? If so, wouldn't it make sense to first implant the best candidates with the worst hearing then as CI technology improves, others will become candidates? There is still so many with profound hearing waiting for a CI!

Where are you seeing people use the 75% satisfaction figure? Every time I've read case studies and talked to CI users, the number has always been 95% or above. As for your assumption that those with greater loss of hearing would find more benefit from a CI, this can't be generalized because no two CI users regardless of hearing loss hear exactly the same with their implants. As for your last question, I think anyone who qualifies for a CI (even if they don't have profound hearing loss) should be entitled to have one. After all, everyone has the right to hear.

7. Your answer: "No one with normal hearing, hearing aids or CI can hear below 250 Hz."
My question: Howcome websites say a normal person can hear frequencies as low as 20Hz? How do you explain I can hear the lowest piano key(27.5Hz) with and without HAs? Also my audiogram shows a 65db loss at 125Hz

Since audis don't test at 125 Hz, the fact that you have a 65 dB loss is moot.

8. Your answer: "What's the point of being able to hear above 6-8 KHz when the frequency range from 250 Hz-8 KHz is enough to understand speech?"
My question: I heard that high frequencies is important for music. I don't care much for music but ive been told thats because music sounds too dull and muddy for me since I only hear low frequencies. I don't even have a good idea what frequencies above 2000Hz sound like but many people, including you say it's annoying. As for frequencies below 250Hz, lots of environmental sounds and bass music encomposes the under 250Hz range.

People with CIs can't hear bass, so again, being able to hear below 250 Hz isn't really important.

.

 

[LadySekhmet]

1. Your answer: "Each person with an implant has their own personal map and in all of the maps that I have seen I have never seen a dynamic range of 10db."
My question: Then explain more about dynamic range and how many db does it span? Is it less or more than 10db?
it's not necessary a DB range, it's more of the range between the highest tolerable sound to the lowest. For Cochlear Freedom, it can go up to 80 DR, but very rarely anyone goes that far. It's usually averages at 30 to 45 or 50. I have DR of 42 in my Left and DR of 32 in my right. It's because I can hear more/better in my right than my left. When I was first activated, I could hear at 10 db line across the board (better than hearing people!)...it was waaaay too much.
2. Your answer: "You get an implant to hear more clearer not louder."
My question: Do you lose the ability to tell how loud a sound is with CI? Also do you miss out on hearing any sounds below your CI treshold? Regarding loudness, doesn't this let you hear faint, low db sounds, such as someone whispering or the rustling of leaves.
no you don't, you actually GAIN the ability to tell how loud the sounds are, that's why some of us HATE high frequency sounds. hearing people cna block them out, but for some of us it's like it's right there in our ear. I can still hear someone whisper, I can hear the clicking on the keyboard from across the room, I can hear crickets. But it's the matter of whether someone wants to actually hear that.


4. Your answer: "The goal of the implant is to make speech more clearer and so they would program your implant to hear at the top of the speech banana."
My question: Then howcome from the audiograms and case studies I read about, the average appears to be 40db treshold? Is it a hardware limitation, a limitation of your cochlea or bad programming? I think it is pretty much all individual basis. For me, I started to be able to hear on the 10db threshold...it got way too much, so they had to lower the maps. I now hear everything on the 20db. It is NOT hardware limitations. So, i think if someone has a lot of residual hearing and lost them, would do fairly better than someone who has been deaf their whole life because they're used to detecting what the sounds are and stuff. Other than that I don't know the answer to this question why the norm is 40.

5. Your answer: "Actually now a days you are not losing your natural hearing in about 1/2 cases. My daughter was implanted 9 years ago and she has all of her natural hearing which wasn't helping her that much anyway."
My question: This is good news to me and everyone else! It makes CI less risky and offers a plan B: going back to your hearing aid(s) in case CI doesn't work or you aren't satisfied. This also could let a person alternate between their HAs and CI and get the best of both worlds as youd hear differently with each. Plus keeping most/all your natural hearing could leave the option for a cure open or make it easier to achieve. In those 50% of cases, do you still lose some, but not all your residual hearing?

I'm one of the few that has residual hearing in both ears, and there's no way in hell I'm going back to HA's. I have tried HA's a few months after activation, and the HA's sounds soooo dull and flat. There's absolutely no high frequency detected at all. While I'm glad that I still have residual hearing, but it's an afterthought. No one wants to alternate between HA's and CI. It will drive them crazy. There are a few that do bimodal approach (although I totally disagree on this, but it does help if one ear has the ability to hear at the same level as CI). I still have ALL of my residual hearing.



8. Your answer: "The goal of a CI is to hear speech and they program so that you can hear most speech sounds.."
My question: Could that person switch/select programs for music or environmental sounds? Is better speech understanding the only real reason to get CI? I always thought it was to simply hear louder/better for all sounds?Oh yes you can switch programs! Cochlear Freedom has 4, AB has 3, and Med-El has 3 (i think?). I have one strictly for music. It's a little TOO crisp for me to use it everyday, one for everyday situations, one for Focus (restaurants, lectures, etc), and last one for quiet (since I get auditory exhaustion after so many hours of wearing CI. For me - Music was the real reason for getting the CI. The Speech part was a huge extra. I didn't realize how much BETTER I can hear. I can hear radio now, I can hear what is being said on the TV without looking at the captions (not 100%, but damn it gets better over time!), hear on the phone, etc. But music was my pretty much sole reason why I got CI.

Hope I gave some insight.

 

[deafdude1]

Hear Again, here's my reply:

A CI bypasses the middle ear by stimulating the auditory nerve. There is nothing to amplify since the eardrum isn't being used nor any part of the middle ear including cillia.

Ok, understood.

Where are you seeing people use the 75% satisfaction figure? Every time I've read case studies and talked to CI users, the number has always been 95% or above. As for your assumption that those with greater loss of hearing would find more benefit from a CI, this can't be generalized because no two CI users regardless of hearing loss hear exactly the same with their implants. As for your last question, I think anyone who qualifies for a CI (even if they don't have profound hearing loss) should be entitled to have one. After all, everyone has the right to hear.

I got the 75% from a few blogs and from comments others left in that blog. I did see a 95% figure from one case study with a large sample. Maybe those who aren't satisfied didn't have realistic expectations or were expecting a big improvement and were disapointed on not getting "enough" improvement over their HAs. Even if a person qualified, that person should be informed of the risks, benefits and have realistic expectations. If that person is expecting results that todays CI is unlikley to deliver on, that person should wait for better CI technology that will then better meet his expectations. Everyone does have the right to hear. Don't insurance companies have the right to refuse to fund you? Then couldn't that person get a medical loan or save up for CI?

Since audis don't test at 125 Hz, the fact that you have a 65 dB loss is moot.

Mine did test me at 125Hz, is it still moot?

People with CIs can't hear bass, so again, being able to hear below 250 Hz isn't really important.

For some people, such as me it is. I didn't know CIs don't work below 250Hz till a few days ago. I am guessing this could explain why some people are disappointed, they never knew about this till getting a CI. I am now curious if anyone here who got a CI was mentioned this fact or only found out after getting CI?

Yes below 250Hz is nearly useless for speech but it matters alot for music and environmental sounds. If speech is what matters the most, then CI has a good chance of working for you. If you like listening to bass drums or the humming and rumbling sounds, youll lose that with CI.

 

[deafdude1]

Hope I gave some insight.

Thanks for your reply.

it's not necessary a DB range, it's more of the range between the highest tolerable sound to the lowest. For Cochlear Freedom, it can go up to 80 DR, but very rarely anyone goes that far. It's usually averages at 30 to 45 or 50. I have DR of 42 in my Left and DR of 32 in my right. It's because I can hear more/better in my right than my left. When I was first activated, I could hear at 10 db line across the board (better than hearing people!)...it was waaaay too much.

Could you explain why 10db aided was too much? I read that normal hearing is 0 to 20db loss so 10db is right in the middle. Could one have a treshold of 10db and set the tolerable/comfort maximum to where you like it? Can a treshold that's too good conflict with tolerable/comfort levels? I find that my aided minimums with HA has nothing to do with comfort levels. Id like to get down to 10db aided if my HA can be programmed. Itll let me hear faint sounds so much better. It can be programmed to give less gain for loud sounds and the most gain for faint sounds.

no you don't, you actually GAIN the ability to tell how loud the sounds are, that's why some of us HATE high frequency sounds. hearing people cna block them out, but for some of us it's like it's right there in our ear. I can still hear someone whisper, I can hear the clicking on the keyboard from across the room, I can hear crickets. But it's the matter of whether someone wants to actually hear that.

How does one tell how loud a sound is if CI doesn't amplify any sounds? I know about treshold and comfort/tolerance levels but do those have anything to do with loudness? If a sound is at treshold levels, is it less loud than at comfort levels? Can one hear "loudness" in between those levels?
I have no good idea what high frequency sounds are like, what makes them so annoying and if they are so bad, why should I bother improving my high frequency hearing then?

I think it is pretty much all individual basis. For me, I started to be able to hear on the 10db threshold...it got way too much, so they had to lower the maps. I now hear everything on the 20db. It is NOT hardware limitations. So, i think if someone has a lot of residual hearing and lost them, would do fairly better than someone who has been deaf their whole life because they're used to detecting what the sounds are and stuff. Other than that I don't know the answer to this question why the norm is 40.

Can anyone better answer this? To those people who end up on the 40db treshold, have they maxed out or could they improve? I always hear of people "hoping" to be 20db, 30db, etc whatever their expectations happen to be. Personally, how well do you hear speech, music and environmental sounds when you adjust your volume/map and compare the difference between 10db, 15db......40db tresholds? Would you still be happy if the best was 40db treshold?

I'm one of the few that has residual hearing in both ears, and there's no way in hell I'm going back to HA's. I have tried HA's a few months after activation, and the HA's sounds soooo dull and flat. There's absolutely no high frequency detected at all. While I'm glad that I still have residual hearing, but it's an afterthought. No one wants to alternate between HA's and CI. It will drive them crazy. There are a few that do bimodal approach (although I totally disagree on this, but it does help if one ear has the ability to hear at the same level as CI). I still have ALL of my residual hearing.

Residual hearing is a great plan B when/if CI ever stops working. Then youd hear *something* while the CI gets repaired or replaced. It's also a plan B if CI does not give better hearing/results than HAs, usually a person with plenty of residual hearing across all frequencies. What about the fact you can't hear below 250Hz with CI, wouldn't one want to wear HAs to hear bass music and CI for speech? Would you say if someone considers keeping their residual hearing after CI as "very important" to be a poor candidate?

For me - Music was the real reason for getting the CI. The Speech part was a huge extra. I didn't realize how much BETTER I can hear. I can hear radio now, I can hear what is being said on the TV without looking at the captions (not 100%, but damn it gets better over time!), hear on the phone, etc. But music was my pretty much sole reason why I got CI.

Thanks for sharing your reasons. My reasons would mostly be to hear all the frequencies from below 50Hz to at least 8000Hz(which frankly even CI doesn't yet achieve and I don't want to lose the ability to hear bass) I don't really listen to music, however bass is my fav music and the music I hear best anyway. Do you ever listen to bass music?

 

[Hear Again]

deafdude,

Since CIs don't pick up bass, you probably wouldn't enjoy the way bass music sounds with an implant.

 

[Hear Again]

deafdude,

When I chose to receive CIs, my primary interest was speech understanding. If I could enjoy music as well (which I do), I considered that a bonus.

 

[LadySekhmet]

Thanks for your reply.



Could you explain why 10db aided was too much? I read that normal hearing is 0 to 20db loss so 10db is right in the middle. Could one have a treshold of 10db and set the tolerable/comfort maximum to where you like it? Can a treshold that's too good conflict with tolerable/comfort levels? I find that my aided minimums with HA has nothing to do with comfort levels. Id like to get down to 10db aided if my HA can be programmed. Itll let me hear faint sounds so much better. It can be programmed to give less gain for loud sounds and the most gain for faint sounds.
Because I was hearing EVERYTHING! The world is really noisy. I could even hear my cat poop. I was able to hear my bf type on the computer in the other room, I was able to hear every single sound that is made through speech (the SH and Z sounds were pretty loud to me), so, it was just a tad bit too much so they just kind of changed the maps so I can hear the lower frequencies better, and the higher frequencies are more quiet. It's just my personal preference.


How does one tell how loud a sound is if CI doesn't amplify any sounds? I know about treshold and comfort/tolerance levels but do those have anything to do with loudness? If a sound is at treshold levels, is it less loud than at comfort levels? Can one hear "loudness" in between those levels?
I have no good idea what high frequency sounds are like, what makes them so annoying and if they are so bad, why should I bother improving my high frequency hearing then?
Okay, maybe I didn't say it right. If you hit a hammer from the other side of the room and you bring it closer and closer, I will be able to hear how loud and how far it is. Hearing Aids amplify sounds ONLY if you have the residual hearing to hear so. So, let say that you only have the nerve hair cells for the higher frequencies, but not high enough...you will bring that up a little with HA's. Having said that, I was NR in the high frequencies...so HA did NOT help, but CI did.


Can anyone better answer this? To those people who end up on the 40db treshold, have they maxed out or could they improve? I always hear of people "hoping" to be 20db, 30db, etc whatever their expectations happen to be. Personally, how well do you hear speech, music and environmental sounds when you adjust your volume/map and compare the difference between 10db, 15db......40db tresholds? Would you still be happy if the best was 40db treshold?

I know if I was at 40 db threshold, it will be way too quiet. So, with speech, music, and environmental sounds I can hear very well.



Residual hearing is a great plan B when/if CI ever stops working. Then youd hear *something* while the CI gets repaired or replaced. It's also a plan B if CI does not give better hearing/results than HAs, usually a person with plenty of residual hearing across all frequencies. What about the fact you can't hear below 250Hz with CI, wouldn't one want to wear HAs to hear bass music and CI for speech? Would you say if someone considers keeping their residual hearing after CI as "very important" to be a poor candidate?
Technically, if someone wants to really consider CI, he/she must expect that he/she will lose what they have. If they consider it very very important, they may consider trying to implant the worse ear or wait, or even turn down CI. It doesn't make them "poor candidate", just unrealistic.


Thanks for sharing your reasons. My reasons would mostly be to hear all the frequencies from below 50Hz to at least 8000Hz(which frankly even CI doesn't yet achieve and I don't want to lose the ability to hear bass) I don't really listen to music, however bass is my fav music and the music I hear best anyway. Do you ever listen to bass music?

Umm I listen to all kind of music, and even bass music (you'll really have to give me an example of a song that has bass sounds 250Hz and below then I'll be able to report to you whether I can hear it or not).

There is a reason why there may be a loss in the bass sounds...the array can only go so far..the cochlear is like a snail. Try threading in a thread all the way to the end...nearly impossible right? Well, the end of the cochlea is where all the low frequencies are placed. That's why surgeons try so hard to push it as far as it can go. If the array is much longer (more electrodes), then it may cause more trauma to the cochlea.
If there's a lot of bass sounds, my residual hearing picks it up. So, in a way I can hear both.

 

[SteveESP52]

I've seen a lot of comments on this thread so I'll add mine along with a little of my experience.

First, a CI will not and never will replace one's ability to hear naturally. If you are a CI candidate, your ability to hear sound naturally is broken. It took millions of years for the cochlea to evolve, an electronic device will not replace it and be perfect. CI's have been evolving for 20+ years now and they are pretty awesome considering how long they have been in use. From reading posts, it seams like around 1999,2000, the number of users started going up pretty fast. I received my 1st one 2+ years ago and my 2nd Bilateral 2 months ago.

Several comments have been centered around the lowest frequency someone with natural hearing can hear. I don't know what it is 25hz but I can hear the lowest piano key just like I could before I lost my hearing. It also sounds the same as I remember it. I can also tell the difference between the keys as each key is played. I can also tell to a degree of accuracy if a key doesn't sound right. I'm not a piano player or really big into music just to let you know.

I lost my hearing in my good ear rather quickly, over 18 months and prior to loosing my hearing, I use to listen to my Television at volume of 10 regularly, Not to loud, not to soft. This is where my family listens to the TV as well. While I was loosing my hearing, I found myself turning the TV up to 18-25 with my hearing aid and missing words and not knowing what was going on during shows so for the most part, I stopped watching TV. Shortly after receiving my first CI, I found that I could once again listen to the television at volume level of 10. Did the CI restore my ability to hear like I could before loosing my hearing, it was pretty close. After receiving my second CI, I found myself listening to shows at volume level of 3 sitting across the room and my wife and kids were asking me to turn up the volume because they could not hear it. Does this mean I can now hear better than they can? Maybe in some situations and maybe not in other situations but it gives me the ability to hear very well again. Without the CI's, I can not hear anything. I feel vibrations before I hear them.

There are so many settings to making a map for a CI that to totally understand how well it can help in someones situation is really hard to predict. Also, how satisfied a CI user is with their CI may be very misleading since there is always key information missing like how long post activation is the survey or how many mapping sessions have they been through. For example, 1 week after activation, I'd bet many CI users may not be 100% happy with it. I sure wasn't. 4 weeks after and 3-4 maps later, does the percentage go up? I'd sure bet it does. How about 6 months or a year later, I bet it is even higher. I also would think that if a CI reciepient doesn't go in for follow-up Mapping sessions, they may not be as happy as someone who is really working their audiologist and the CI's ability to turn sound into electrical signals.

I am extremely happy with my 1st CI after 2 years 2 months. My 2nd CI at 2 months old, I'm still working with my Audiologist to get the MAPs right but it is well on its way. My cochlea is still healing and my brain is also still getting use to the stimulation of L and R inputs. The programing is probably at 80%. I'm guessing at 12 months, it will be almost to the level of my 1st CI.

Again, with all the settings, you have the T and C levels which are the range of electrical stimulation levels that the brain interprets as sound and the max the user sets as the highest stimulation they feel they want to hear. Aside from this, there are settings for the minimum sound volume the CI will pickup and start sending signals for. Typically this is the "sensitivity" settings the user can control. There are others that are set in the program that the user is not able to redily adjust. CI maps can be set for "auto sensitivity" which is nice in some situations where constant noise is cancelled out. The level where the auto sensitivity starts cutting out constant noise can be adjusted during programming. If I understand how it works correctly, I use to have the setting set at 69db so if there was any constant noise louder than 69db on any frequency, it would be shut off. During one mapping session, we changed it to 71db and what a big difference. For me, the biggest change was being able to listen to the radio at a normal volume instead of 1/2 volume. This was on my autosensitivity maps. I had manual control maps that I would set or adjust which would give me the ability to hear the radio but I'd have to play with it a little ever so often.

I guess I better stop typing since it is getting late but as I see it is if a CI reciepient can hear each of the electrodes, soft and loud levels at initial activation, time and working the programming sessions will bring the users ability to hear sound and speech around where they will most likely not regret their choice of having a CI. I really like having mine. I have the choice if I want to hear the world or not. All I have to do is take it off. For this reason, I'd have to think really hard to have a totally implantable CI that can not be turned off. It is nice to give the brain a break from the noise. My wife is at times extremely jelous that I can shut off the world.

Again, getting a CI is a personal choice for each person given their experiences in life. Do not let anyone influence your decision. Read up as much as you can. Learn as much as you want. Push your Audi as much as they are willing to be pushed to help you hear if you choose to get a CI. If you don't think you are getting out of a CI what you think you should be, start asking questions, keep track of what you can hear and what you can't. Ask if you should try a different approach with base program settings, speeds, ETC. If you still don't think you are getting what you want, may be time to adjust your expectations and re-evaluate your progress. Make sure you are not hoping for a perfect solution. A CI does require work and some adaptation. You might need to look for another programming center if you still feel it should be working better than it is.

Good luck with your decission. Please ask questions. You need to be happy with your choice.
Steve

 

[SteveESP52]

Deafdude,

Saw a question regarding can a CI be to loud in another post and remembered I forgot to mention anything on that.

Absolutely a CI can be to loud. If you have your volume setting set to high just like a HA or if you have your Sensitivity setting to high. Another way it can be to high is if you have your T levels set to high which is the softest electrical stimulation your brain picks up. If you set all your T levels to high, the CI will be sending what it is programed to send as a 60db stimulation but you might be hearing it as a 70db stimulation thus everything is to loud.

This is why having sufficient programming sessions and not being rushed through the session is SO important to get the most out of the CI.

Steve

 

[LadySekhmet]

I found a website that gives the lowest frequency to highs that a hearing ear can hear..20Hz to 20,000Hz. I found that I can hear from 40Hz all the way to about 15,000Hz. So I have no idea why people have said that the CI cannot hear anything below 250Hz. Besides, something that low will be something like a motorcycle. However, almost all bass sounds have other additional sounds to it, so it's not always 50Hz or 250Hz constant...if so, that can actually cause hearing loss (can it?)

 

[deafdude1]

Thanks again for your answers!

Different kinds of implants: Auditory, Penetrating and Hybrid

Can anyone comment on a hybrid CI that used a modified shortened array with some 6 electrodes to allow a person to hear high frequency while still preserving much of your residual low frequency hearing? It's very common to have a sloping loss where the residual low frequency(125, 250, 500Hz) hearing is usually 40db to 80db loss while the high frequencies(usually 2000Hz and up) may have 100db to over 120db hearing loss. That article explains the benefits of a hybrid CI and says this will become the most widely used.

SteveESP52, thanks for your long post. What did your hearing used to be before it got worse, right before getting CI and what's your T and C levels with CI? Do you have any audiograms? Of course a CI isn't a cure nor will it give "normal" hearing. The question/debate is who is a CI candidate and based on what criteria? I keep hearing different criteria depending on the sources. I fear that the sources that are the most lax on criteria is going to have a much lower satisfaction rate than the sources that are the most conservative.

Several comments have been centered around the lowest frequency someone with natural hearing can hear. I don't know what it is 25hz but I can hear the lowest piano key just like I could before I lost my hearing. It also sounds the same as I remember it. I can also tell the difference between the keys as each key is played. I can also tell to a degree of accuracy if a key doesn't sound right. I'm not a piano player or really big into music just to let you know.

A young human with perfect hearing supposedly hears from 20Hz to 20KHz. But from what I read, it's the high frequencies that can no longer be heard as you age or lose hearing since it's located at the entrance of your cochlea while the low frequencies are located all the way at the center where it's protected. That also explains why 90% of the audiograms are sloping with the most residual hearing at low frequencies. I do wonder how important being able to hear above 6-8KHz is. That's outside speech and the majority of environmental sounds and music.

That's interesting you still hear 27.5Hz as well as being able to differnate each piano key. Is it some special music map you have? Can you explain why many can't hear very low frequencies with CI and you can? That's news

I really like having mine. I have the choice if I want to hear the world or not. All I have to do is take it off. For this reason, I'd have to think really hard to have a totally implantable CI that can not be turned off. It is nice to give the brain a break from the noise. My wife is at times extremely jelous that I can shut off the world.

A totally implantable CI is still not a cure. Youd be able to program it with a remote control including turning it on/off. Even if the remote breaks, the internal rechargable battery will die in 12-24 hours. Those with totally implantable CI aren't precluded from alternating using an external speech processor. If your wife is jealous, can I trade ears with her? I can always wear earplugs to shut off the world.

Again, getting a CI is a personal choice for each person given their experiences in life. Do not let anyone influence your decision. Read up as much as you can. Learn as much as you want.

This is why I am asking so many questions and learning new things. CI is indeed a personal choice and a $50,000 choice if insurance can't/won't fund you. How common is it for people to get a CI out of pocket? Say they don't qualify per insurance criteria but they still want a CI and the surgeon is willing to implant that person?

I found a website that gives the lowest frequency to highs that a hearing ear can hear..20Hz to 20,000Hz. I found that I can hear from 40Hz all the way to about 15,000Hz. So I have no idea why people have said that the CI cannot hear anything below 250Hz. Besides, something that low will be something like a motorcycle. However, almost all bass sounds have other additional sounds to it, so it's not always 50Hz or 250Hz constant...if so, that can actually cause hearing loss (can it?)

They say that because a CI doesn't quite go all the way in a cochlea. Maybe your surgeon did an exceptionally good job of inserting the electode array nearly to the center of your cochlea. As for the high frequencies, those are present at the entrance of the cochlea so I am not surprised there. When you visit any store that has electronics and computers, walk to a demo subwoofer and listen closely. If you do hear low frequencies, youll notice a deep rumbling sound like "ooooooooh" itll sound like giant drums rumbling. Youll of course also be able to feel the vibrations. Test with the CIs turned off and compare the difference. You don't have to worry about hearing loss(unless loud sounds can damage a CI) but a normal ear should avoid prolonged exposure to loud sounds.

 

[LadySekhmet]

A young human with perfect hearing supposedly hears from 20Hz to 20KHz. But from what I read, it's the high frequencies that can no longer be heard as you age or lose hearing since it's located at the entrance of your cochlea while the low frequencies are located all the way at the center where it's protected. That also explains why 90% of the audiograms are sloping with the most residual hearing at low frequencies. I do wonder how important being able to hear above 6-8KHz is. That's outside speech and the majority of environmental sounds and music.

Hmm - Honestly, to be able to ear the very highs is really annoying and it physically hurt. Imagine having a whistle or a flute playing the highest note in your ear every day...it hurts. To me it does. For other people, it's beautiful. I *could* bring up my map to be able to hear above 6k, but it was just WAY too much for me. So, it's more of personal preference. You're right, that you lose the very high frequencies first as you age...that's why many teenagers have cellphone ring tones to the very high pitch because they can hear it, but teachers can't. Nowadays, schools put a blockage on signals.

That's interesting you still hear 27.5Hz as well as being able to differentiate each piano key. Is it some special music map you have? Can you explain why many can't hear very low frequencies with CI and you can? That's news

You know, i actually do not know why...I think it's because their loss is much more profound, or the array is not inserted deep enough (some surgeon takes 1 hour or 1 1/2 hours to do implantation, others take their time..like mine, which was 4 to 5 hours). So, it's possible that the end of the array is not deep enough. Cochlear Freedom implant has the longest, with 22 electrodes. So, maybe the ones that did not get the low frequencies have the shorter arrays...AB has 16, Mel-El has 12.


I don't know about Steve, but I do have a specific map for music. Ironically, it adds all the much higher frequencies and more lows than what I would use for my everyday program because I know I don't want to hear the highs for 15 hours straight, it gets tiresome (auditory fatigue). So, unless if a CI user is a music lover, they more likely will have a specific music MAP because music is very different than environmental/speech. If the CI user is not a music lover, they most likely wouldn't care much for music program, however, they may start liking music better because they have the clarity...but lack experience in listening in music because they didn't listen to music prior implantation. The more you are exposed to music before implantation, the much better you know exactly how you want it to sound. I prefer the vocals, so my map is specifically made to sort of filter out the background music and bringing the vocals up. Think of this as an equalizer. If someone prefer to hear the bass (such as you), you can filter out the higher frequencies and be able to pick up the bass a lot more. I personally don't like very bass music because it vibrates my ear since I can hear through CI AND my ear, so it's a little too much..it's like having a sub woofer right in my ear.

This is why I am asking so many questions and learning new things. CI is indeed a personal choice and a $50,000 choice if insurance can't/won't fund you. How common is it for people to get a CI out of pocket? Say they don't qualify per insurance criteria but they still want a CI and the surgeon is willing to implant that person?

You'll be surprised how UNCOMMON for an insurance company will pay for one. It's common that they won't pay for two! So, the major insurance companies are more likely will pay for one...such as BCBS, Medicare (80%), Mediaid, Aenta, AARP, and couple others.

If you do hear low frequencies, youll notice a deep rumbling sound like "ooooooooh" itll sound like giant drums rumbling. Youll of course also be able to feel the vibrations. Test with the CIs turned off and compare the difference. You don't have to worry about hearing loss(unless loud sounds can damage a CI) but a normal ear should avoid prolonged exposure to loud sounds.

The slight problem with that is: I can still hear it through my residual hearing...it sounds softer than with CI, and CI has the clarity so it's like I can pick up the differences a lot quicker and easier than without it turned on. I'm asking what SONG, would have bassy sounds? I don't normally listen to bassy music, so I'm just curious if I can really pick it up well, or "okay".

Sorry so long!

 

[Hear Again]

I'm a music lover, but I don't have a music program on my CIs. My audi thought it would be easier for me to have autosensitivity enabled to help with my dizziness as well as to keep all 4 maps identical so that I didn't have to cycle between them in order to find the program I wanted. It's not really a big deal to switch programs, but I've grown to like the convenience of not having to worry about which map I'm on if I accidentally bump the program button. However, when I see my audi on April 8th for further testing, I'm going to ask her to create a softer map for whenever I'm overly sound sensitive.