Poor aided results above 500Hz

Originally Posted by Hear Again
I was wearing Oticon DigiFocus II super power BTEs at the time.

Originally Posted by deafdude1
Ill look up the specs for those, but off the top of my head, aren't those almost as good as Phonak Naida V UP?


The Naidas weren't available back in 2004 when I was evaluated for my first CI.
 
You also said that when the gain was increased, you experienced distortion and it didn't help improve your speech perception? Did it still improve your ability to hear more environmental sounds? If you say 60db wasn't good enough, what stopped you from maxing out the gains? Regardless not hearing above 750Hz and with how little residual hearing you had, a CI was fine for you. In my case I feel I can and should be getting better than 80db at 2000Hz! I don't care if theres a bit of distortion!

In my case, icreasing the gain on my hearing aids did not result in an increased ability to hear environmental sounds. The distortion I heard made environmental sounds very difficult to hear since I couldn't recognize what I was hearing. Once the gain was turned down, I experienced more clarity.

I already indicated that my audi maxed out the gain on my analog and digital aids despite the fact that this went against her recommendations. See this post for details:

http://www.alldeaf.com/1280899-post4.html
 
In my case I feel I can and should be getting better than 80db at 2000Hz! I don't care if theres a bit of distortion!

The difference between you and I though is that I wanted to understand speech. You, on the other hand, are satisfied with being able to hear environmental sounds.
 
The questions are for my knowlege. I am not qualified to make decisions for others(just state my opinion and let them decide) and in fact this thread isn't even about CI, just my own hearing results.

I'm afraid that you're the one who turned this into a debate about who should receive CIs and who shouldn't given how many questions you've asked several of us about how much speech discrimination we had pre-CI and how much gain, etc. we had on our hearing aids. You even went so far as to question myself, cdmeggars and faire_jour about our choices for having a CI. Once you were convinced of the fact that I had very little residual hearing before I received my first CI, you seemed comfortable with my candidacy for an implant. So yes, you DID make this a thread about CIs and who should and shouldn't be implanted.
 
My Q: Has transposition been programmed on my hearing aids, if yes what frequencies become transpositioned? So far I have not been able to notice any transposition, maybe it should be reprogrammed?
His A: It has been programmed. if you do not notice it, then it is working correctly.


This isn't what my former CI audi told me. She said that if transposition aids are programmed appropriately, you should be able to hear a very different sound compared to regular hearing aids. What exactly that sound is, I can't say since I've never worn them.

However, she did say that the sound of transposition aids is considerably different than regular hearing aids. This is why she said many people have alot of difficulty adjusting to transposition hearing aids.

My CI audi is the senior audiologist at my CI center. She wasn't the one who evaluated me for my CIs, but I'll ask her to describe how much different transposition aids sound compared to regular hearing aids.
 
deafdude,

I just wanted to let you know that I heard from my CI audi this morning. She will be sending me copies of my latest audiogram as well as my audiogram prior to having 6 electrodes on each CI turned off.
 
Severe hearing loss starts at 70 dB, so this person DID have severe-profound hearing loss.

Which person? But I read about a few who have/had less than 70db still get a CI. I also remember you mentioning that you also know of a few with only a moderate low frequency loss but profound high frequency loss who got CI

How come you're able to hear unaided at 3 and 4K, but you receive NR aided?


This is one of the confounding questions I have for the audiologists and have posted it here. I have several theories, the most plausable one is that my hearing got worse. I have done aided and unaided tests on my computer using the speakers and online hearing tests and I can't hear 3000Hz aided or unaided.

It could be possible that my tinnitus occured coincidentally at the same time my audie played a 4000Hz tone. Is it supposed to be pulsed(come and go) and sound like a bird chirping? It sounded like "eek....eek.....eek" while the other sounds were continous beeps lasting a duration of 2-3 seconds. I actually wasn't even sure if it was tinnitus or if I actually heard the sound but I raised my hand anyway.

Ive read about cochlear dead spots but its not very likley it happened in my case, usually a such person has a very steeply sloping loss that levels off near 120db and the sounds aren't directly heard but felt, one guy said it felt like a burst of air wooshing into his ears. Play anything loud enough and you can feel the air wooshing out of the speakers. I felt that from my computer speakers.

A third possibility is the audiometer was distorting high frequency sounds and I heard a lower frequency. Ill get more answers when I visit on the 24th(a different audie) and if I respond above 2000Hz, ill ask her to retest me, letting me know "this is 3000Hz" and ill describe what I hear or find out it was a false positive(tinnitus possibility) if I hear nothing upon a retest.

In my case, icreasing the gain on my hearing aids did not result in an increased ability to hear environmental sounds. The distortion I heard made environmental sounds very difficult to hear since I couldn't recognize what I was hearing. Once the gain was turned down, I experienced more clarity.

I already indicated that my audi maxed out the gain on my analog and digital aids despite the fact that this went against her recommendations. See this post for details:

AllDeaf.com - View Single Post - Poor aided results above 500Hz

Can you describe what the distortion sounded like and why was it occuring for you? I notice very little, if any distortion and the distortion is comming from the speakers if I max out the speaker's volume. I can also feel the speakers vibrating as further proof of distortion.

The difference between you and I though is that I wanted to understand speech. You, on the other hand, are satisfied with being able to hear environmental sounds.

For me, environmental sounds are the most important. Ive never had good understanding of speech nor do I have any concept of understanding speech so I don't miss what I never had. I have CC on TV, don't care for phones and am exceptional at reading lips. I also don't socalize much in person. When I move out of my parent's house I can go days without talking to anyone in person and if I talk to someone, no problem reading lips, also I can email and instant message that person as well as others. So I am focusing on hearing the most environmental sounds(even if they are a tiny bit distorted which I tend not to notice)

This isn't what my former CI audi told me. She said that if transposition aids are programmed appropriately, you should be able to hear a very different sound compared to regular hearing aids. What exactly that sound is, I can't say since I've never worn them.

However, she did say that the sound of transposition aids is considerably different than regular hearing aids. This is why she said many people have alot of difficulty adjusting to transposition hearing aids.


I noticed no difference except I hear low frequencies much better than with my old HAs. The mid frequencies were slightly louder, most of the extra improvement was in the low frequencies. I notice lots of humming/rumbing/growling sounds comming from cars, air vents, fans, men's voices, etc. Also with both the new and old HAs I can't hear 3000Hz and above. Either transposition hasn't been programmed or is programmed above my capability to hear.

deafdude,

I just wanted to let you know that I heard from my CI audi this morning. She will be sending me copies of my latest audiogram as well as my audiogram prior to having 6 electrodes on each CI turned off.

Thanks so much for your time! Me and others learn so much from your posts and replies! :)
 
Which person? But I read about a few who have/had less than 70db still get a CI. I also remember you mentioning that you also know of a few with only a moderate low frequency loss but profound high frequency loss who got CI

The person you mentioned in your post.
 
Can you describe what the distortion sounded like and why was it occuring for you? I notice very little, if any distortion and the distortion is comming from the speakers if I max out the speaker's volume. I can also feel the speakers vibrating as further proof of distortion.

The distortion I heard sounded like a radio turned up as high as it can go volume wise.

According to my CI audi and former hearing aid audi, the distortion occured because I do not have alot of remaining cillia and I did not have any residual hearing at 1000 Hz and above.
 
Thanks so much for your time! Me and others learn so much from your posts and replies!

You're welcome! :)
 
deafdude,

Here's the e-mail I received from my CI audi re: transposition aids.

My e-mail is first, followed by her response.

"I have another question. How does the sound quality of transposition
aids differ from standard hearing aids? Is the sound quality
significantly different? When I asked Farah if I could try transposition
aids during my first CI evaluation, she told me I would most likely have
alot of difficulty adjusting to them given the fact that I've worn
analog BTE hearing aids since 1985."

"Yes-transposition aids sound very different. You are better off with
the implants."

My CI audi's statement about me being better off with CIs was also based on my aided/unaided pre-CI audiogram as well as my speech discrimination of 8% in my left ear with a Comtek FM system using DAI and Oticon DigiFocus II super power BTE hearing aid and 22% speech discrimination in my right ear (also with Comtek FM system and Oticon DigiFocus II super power BTE).
 
I also remember you mentioning that you also know of a few with only a moderate low frequency loss but profound high frequency loss who got CI.

All of these individuals either had ossification of the cochlea or rapidly progressive hearing loss. Hence, the reason they were CI candidates.
 
Also - not all of us have a nice gain in HA's like yours, DeafDude1. I've wore HA's my whole life, and I was able to understand speech pretty well, but I cannot look away and be able to pick it up easily as I could with CI.

I got the CI because my hearing was progressively getting worse, and I knew it would get to the point where NO HA will help. I do not get any type of clarity that I want/need, and the ability to hear in the higher frequencies that would be almost impossible for me to hear without the CI. You have better "hearing" than I do in the lows. Each person is very different from one another. For you, HA is a success story, so I'm impressed.

For me, having Bilateral CI's is a success story. It works perfectly fine, and I can hear 10db - 20db across the board (with exception of 25db, possibly since I wasn't tested yet, in the very high frequencies above 2500hz). I still have to go for MAP sessions and stuff, so there's still a lot of room for improvement. To be honest, there's more ways to adjust a CI than there is for a digital Hearing aids. Not all audiologists have the expertise like yours, so you are very lucky. :)

Also, if your audiologist is willing, and still can't figure out why you're not getting the gains that you want, you can always request a representative to come over and test it out on you. A lot of CI audiologists do allow representatives to come over to work out the kinks and issues for CI users, and more often the CI user is more than satisfied with the results. Reps pretty much is more of an expert, so it's nice to have them come over and help out. Maybe there's a small thing that your audiologist overlooked, or didn't think about how to program and stuff.
 
Residual hearing won't alter the results of a CI, but can be useful for a person that alternates between HAs and CI or isn't happy with CI and can fall back on HA. It's also used for hybrid CI designs. How much residual hearing did Kat lose, if any after CI? Some of us consider keeping our residual hearing a big deal and im seeing CI designs and implementation change to increase the odds a person won't lose all their residual hearing.



Perfect hearing is 0db. I know that todays CI is incapable of getting to 0db, in fact I read the average results was 40db. The fact she got between 15db and 25db is an excellent result. 25db is the minimum that is considered "normal" hearing and she reached that so she is getting speech sounds as expected. I did see that the speech banana extends as far up as 10db for 100% comphrension. 25db would get you pretty high up anyway and would be better than average for CI(or HAs in severe-profound hearing for the matter)



Thanks for letting me know. In my case, more gain helps, especially with hearing more environmental sounds. Ive turned the volume down on my HAs and it only made it harder to hear everything, including speech. I am surprised she is getting so much distortion, do you know why? The sounds I hear sound normal to me and when I repeat what I hear, my parents say I repeat it correctly. I only need to get more gain above 500Hz then ill hear speech much better. My audiologist also said if my high frequency hearing loss was a few db less, id hear perfectly with HAs. I know everyone is different. They should design HAs that distort less and benefit everyone with residual hearing.



Would an open set consist of monosyllable words, including rhyming words? What % is she up to with CI so far? Since everyone is different, howcome some people with hearing worse than hers scores better on speech perception? My audiologist who sold me those HAs says I have the best speech perception for my level of hearing loss he's ever seen and thinks with practice I could get it to a decent %. I know that with CI you still need lots of practice.



This is news to me. The speech banana covers 125Hz to 8000Hz and some graphs show it extending even below and above that. Also theres lots of low frequency environmental sounds, may I ask if her ability to hear environmental sounds changed? When/if do you plan to go bilateral for Kat?

I am surprised it was so easy for you to get approval from insurance, especially with the amount of residual hearing she has. Ive read lots of stories of how profoundly deaf people struggle for months or years to get approval and some still never get approval and need to pay out of pocket for CI or stick with HAs. Ive always read that severe-profound loss was required and one of them had a graph showing minimum of 75db at 250Hz, 85db at 500Hz, 95db at 1000Hz and up. Have requirements recently become much more lax? Thanks for your answers, so much I can learn! :)

Very few people have hearing at 0 db. 0 decibles is defined as what a normal hearing adult could detect at each frequency, 50% of the time. To think that you can get to that why turning you hearing aids all the way up doesn't seem logical to me.

Also, we wanted speech, not just enviromental sounds, so we didn't care about keeping her residual hearing. It was useless without amplification anyway.

As for her loss, I believe severe starts at 70 across all frequencies, so she was very very nearly there.

Bilateral, we haven't decided about. Insurance may not cover it, and she does get benefit from her aid, so we have time to spare.
 
Which person? But I read about a few who have/had less than 70db still get a CI. I also remember you mentioning that you also know of a few with only a moderate low frequency loss but profound high frequency loss who got CI

The person you mentioned in your post.

Miss Kat? She had only 60db loss at 250Hz but her parents made the choice to implant her with CI. It did help improve her speech perception.

The distortion I heard sounded like a radio turned up as high as it can go volume wise. According to my CI audi and former hearing aid audi, the distortion occured because I do not have alot of remaining cillia and I did not have any residual hearing at 1000 Hz and above.

I will have to read and learn more about this. If the distortion was comming from your ears, what does it have to do with HAs? If it's comming from HAs, then some HAs distort more than others with their gain/volume cranked up. If a person hears much less distortion with less gain from their HAs, shouldnt a different HA give more gain with less distortion?

All of these individuals either had ossification of the cochlea or rapidly progressive hearing loss. Hence, the reason they were CI candidates.


There is one with only 55db HL at 250Hz but it slopes down into nothing in the high frequencies. Ill have to ask her about ossification and if her HL is still progressing. She started losing her hearing at 14. At first she decided against a CI but is now interested in trying a CI in her worse ear(the one with 55db sloping loss) her surgeon is going to use a shortened array and insert it very carefully to try to preserve her low frequency hearing as much as possible. She may use a hybrid CI with a HA for low frequencies and a CI in the same ear for high frequencies. She really wants to regain her high frequency hearing. I am still surprised but it's her choice and ive wished her luck :)

I got the CI because my hearing was progressively getting worse, and I knew it would get to the point where NO HA will help. I do not get any type of clarity that I want/need, and the ability to hear in the higher frequencies that would be almost impossible for me to hear without the CI. You have better "hearing" than I do in the lows. Each person is very different from one another. For you, HA is a success story, so I'm impressed.
That makes sense. You probably had a good idea of what you were missing as your hearing worsened. I don't have a good idea of what im missing unless I try one of my old HAs or if I turn the volume down. What I hear currently sounds normal to me, I am the one who's surprised that others hear so much better, it's like they have super hearing :giggle:

I have no concept of what clarity is, I just know I can't hear mechanical voices. Human voices(especially male) I can hear some words without lip reading. I get by great reading lips, don't care for phones, communicate by email and IM and have CC on all TV so I consider environmental sounds more important. HAs are a success so far in the lows but they leave alot to be desired in the highs. May I ask what your aided audiogram was for HA? Did you experience distortion, recruitment, etc if the audiologist attempted to max out the gains? This is one thing I don't understand as I never experienced any of that.

For me, having Bilateral CI's is a success story. It works perfectly fine, and I can hear 10db - 20db across the board (with exception of 25db, possibly since I wasn't tested yet, in the very high frequencies above 2500hz). I still have to go for MAP sessions and stuff, so there's still a lot of room for improvement. To be honest, there's more ways to adjust a CI than there is for a digital Hearing aids. Not all audiologists have the expertise like yours, so you are very lucky. :)

Your results is the best ive ever seen with CIs, in fact too good :lol: hope your brain gets used to all the extra sounds so you can use the 10db map more often, that's considered normal hearing. You also hear from 40Hz to 15KHz, an exceptional range for CI. I read that a realistic range is 250Hz to 8KHz. Are you even able to tolerate such high frequencies? Must be pretty interesting the first time you heard 8KHz to 15KHz :D

Also, if your audiologist is willing, and still can't figure out why you're not getting the gains that you want, you can always request a representative to come over and test it out on you. A lot of CI audiologists do allow representatives to come over to work out the kinks and issues for CI users, and more often the CI user is more than satisfied with the results. Reps pretty much is more of an expert, so it's nice to have them come over and help out. Maybe there's a small thing that your audiologist overlooked, or didn't think about how to program and stuff.

The audie who sold me those HAs lives in Toronto, he's also my 2nd cousin and I got the new HAs when me and my family visit extended family in Toronto. I didn't have the knowlege about HAs as I do today otherwise I would have asked more questions and got the issues resolved. He basically just told me not to worry, wear those HAs and train your brain to get used to the new sounds which ive done. Several months later, I find a few things that need improving. I will email my audie again as I didn't recieve a second reply with my additional questions. As for a representative, could I get one that works at Phonak to figure out why their HA is giving me half the gain it should at higher frequencies?

Very few people have hearing at 0 db. 0 decibles is defined as what a normal hearing adult could detect at each frequency, 50% of the time. To think that you can get to that why turning you hearing aids all the way up doesn't seem logical to me.

Ive always been told that 0db was perfect hearing and that normal hearing is actually up to 25db hearing loss. A person that hears 25db across the board aided or better yet unaided should have no problem understanding speech. The average adult person with normal hearing probably hears around 10db from 250Hz to 4000Hz and slightly less at 8000Hz, which gets worse the older the person is.

Also, we wanted speech, not just enviromental sounds, so we didn't care about keeping her residual hearing. It was useless without amplification anyway.

Did she keep her residual hearing anyway and how much of it? When/if I ever decide to get a CI, keeping my residual hearing is very important. It may be nearly useless without a HA but I hear plenty of enviromental sounds and some speech with HAs. What if the CI doesn't work right or isn't as good as I was getting with HAs? No person has a 100% chance of success, not even a "perfect" candidate. By keeping the residual hearing, I have a plan B to go back to HAs. I also can alternate between HAs and CI because I read that a CI usually doesn't do a great job below 250Hz and a HA lets me hear low frequency environmental sounds and bass music. Alot of the people I know also consider retaining residual hearing to be important and for reasons similar to mine. Each person's different, but I can speak for myself and many others I know.

As for her loss, I believe severe starts at 70 across all frequencies, so she was very very nearly there.

Was it a progressive loss? Someone else said they can make exceptions below 70db if the loss is rapidly progressing anyway.

Bilateral, we haven't decided about. Insurance may not cover it, and she does get benefit from her aid, so we have time to spare.

Are you waiting for better CI technology for her other ear or even a cure? Ive read about totally implantable CI, 128 electrodes, fiber optic/laser CI electrodes and several other exciting technological prospects that get ME excited about wanting CI. Of course the prospect of a cure is a wildcard. A cure is a question of when, not if. Could be 10 years, could be 25 years no one knows. I have time to spare as well. If I was born the same time Kat was, it's possible my parents would have made the choice for me to get a CI for the same reasons you got one for Kat. CI technology was very crude, primative and expermental when I was a young child. It was only done on those who were 100% stone deaf. I made do with HAs quite nicely and got lots of speech training as a kid. My speech pronunciation and lip reading is now excellent and I can hear some speech too. My hearing was much worse than kat's too. Our generation will be able to get the choice of CI as an adult and no harm was done, at least not to me.

Thanks again for all your replies and answers. Is anyone else here getting poor aided results above 500Hz? I feel im the only one :(
 
That makes sense. You probably had a good idea of what you were missing as your hearing worsened. I don't have a good idea of what im missing unless I try one of my old HAs or if I turn the volume down. What I hear currently sounds normal to me, I am the one who's surprised that others hear so much better, it's like they have super hearing :giggle:

I have no concept of what clarity is, I just know I can't hear mechanical voices. Human voices(especially male) I can hear some words without lip reading. HAs are a success so far in the lows but they leave alot to be desired in the highs. May I ask what your aided audiogram was for HA? Did you experience distortion, recruitment, etc if the audiologist attempted to max out the gains? This is one thing I don't understand as I never experienced any of that.

Your results is the best ive ever seen with CIs, in fact too good :lol: hope your brain gets used to all the extra sounds so you can use the 10db map more often, that's considered normal hearing. You also hear from 40Hz to 15KHz, an exceptional range for CI. I read that a realistic range is 250Hz to 8KHz. Are you even able to tolerate such high frequencies? Must be pretty interesting the first time you heard 8KHz to 15KHz :D

I'll have to find my audiogram aided. I believe it starts at the 40db at 250hz, then slopes downwards a little, and ends up at the 60db in the highs. I have to double check.

Distortion - basically I was missing the higher frequencies that are in speech and environmental sounds, so everything sounded like they were in the lows. If there was strictly high frequencies, such as crickets, birds, S, Z CH sounds, I was not able to hear it at ALL. For example...if someone said to me "school", I would only get the "hool" sound, not the S and CH. The environmental sounds wasn't that much different than wearing my CI, because the majority of them falls in the lower range, however, the sounds are more crisp more clear. Like - I don't have to think twice or thrice of what the sound of a car with bad transmission sounds like, same thing goes for sirens. I used to "hear" the sounds, then have to really think what the sounds are because they're not exactly clear. Now, with the CI, I hear the sound, and I automatically know what it is because I have the clarity that I need. You probably will never experience clarity until you have CI or better HA technology.

I agree that HA has issues with the highs. Again, if you don't have enough high frequency residual hearing, you won't get the same level as you would with the lows. If someone has a straight across the board loss, then they will be able to hear in the high frequencies. I'm NR in the highs, how can I expect HA will bring over 120db loss to the 20db line??? Impossible. CI arrays bypasses the "hair" that is needed to detect the highs, instead, it touches right at the nerve cell. So, think of it this way. The hairs are gone, but the root is still there and still functioning. The array is touching the root, therefore, I'm able to hear in the highs. The highs are the first to go when you get older...it's not the nerves root that is gone, it's the hair that is gone.

Maybe I will increase the MAP over time to reach the 10db, but it's not all that great because you can hear EVERYTHING...I don't think it's important that I can hear my cat poop in the litterbox. I don't think it's that important to hear the A.C. on and hear every sound associated with it. I'm sensitive to high frequencies. I don't want to hear the buzzing of the florescent lightbulb. I don't want to hear the electricity crackling from time to time through an outlet plug (that's was a very interesting experience, but I don't want to hear that on top of everything else). If I hear the highs permanently, I'll go insane. It causes migraines and tinnitus (yes, even some CI users still experience tinnitus...some better than it was, some completely cure, others worse).

If you want to hear all that, be my guest. :)
 
Miss Kat? She had only 60db loss at 250Hz but her parents made the choice to implant her with CI. It did help improve her speech perception.

Just because she "only" had a 60 dB loss at 250 Hz doesn't mean she could hear well. Remember, she also had severe to profound loss in the mid and high frequencies. She also lost her hearing over time. Faire_jour, please correct me if I'm wrong.
 
I will have to read and learn more about this. If the distortion was comming from your ears, what does it have to do with HAs? If it's comming from HAs, then some HAs distort more than others with their gain/volume cranked up. If a person hears much less distortion with less gain from their HAs, shouldnt a different HA give more gain with less distortion?

The distortion was coming from my ears and my hearing aids. Whether I wore hearing aids or not, speech sounded distorted.

As for your second question, I couldn't use a different hearing aid because the Oticon DigiFocus II super power BTE was the strongest hearing aid avaiable on the market when I was evaluated for my first CI.
 
There is one with only 55db HL at 250Hz but it slopes down into nothing in the high frequencies. Ill have to ask her about ossification and if her HL is still progressing. She started losing her hearing at 14. At first she decided against a CI but is now interested in trying a CI in her worse ear(the one with 55db sloping loss) her surgeon is going to use a shortened array and insert it very carefully to try to preserve her low frequency hearing as much as possible. She may use a hybrid CI with a HA for low frequencies and a CI in the same ear for high frequencies. She really wants to regain her high frequency hearing. I am still surprised but it's her choice and ive wished her luck

Why are you surprised that this person wants to have a Hybrid CI? Given her hearing loss, it seems to me like she would be a perfect candidate.
 
Miss Kat? She had only 60db loss at 250Hz but her parents made the choice to implant her with CI. It did help improve her speech perception.

Just because she "only" had a 60 dB loss at 250 Hz doesn't mean she could hear well. Remember, she also had severe to profound loss in the mid and high frequencies. She also lost her hearing over time. Faire_jour, please correct me if I'm wrong.

Yes. She was born hearing but had a moderate loss by 18 months. She lost more and more hearing until, at 5, she was severe to profound. She had 60 at 250 but 105 at 2000.
 
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