Civil Service Test With Audio--Sonnet Processor

[Travel]

Hi Guys,

Getting ready to apply for a PA Civil Service position.  In investigating the civil service testing it states that it will be done via the computer.  I noticed on their site that computer testing can involve audio with headsets.  Oh my!  I have no idea how I would do with a headset as I haven't tried one since my cochlear implant activation 7 months ago.  The telephone is certainly still an iffy situation.  Mostly at home I use speaker phone as I have a small amount of very low tone hearing in my non-implant ear.  So far holding the phone receiver to the processor with the mic is not good.  I can blunder my way through with the telecoil with people I am familiar with.  That being said it gave me a number I could call for disability accommodation.  When I phoned the head of their ADA & Testing Center Coordinator, she was quite stumped by what could be done to accommodate the audio portion. She had no idea how the headphone portion worked in the normal non-ADA testing.  Has anyone had any experience with this?  I explained to her how I put a different battery pack cover & cable on my processor to use to plug into my Ipad when listening to audio books.  She wanted to know the name of the specific device(s) & then said maybe she could investigate to see if an accommodation could be made to use this.  Anyone??  Also if you think the cable with the diff battery cover will work, can you give me the specific lingo I should be using to explain these devices?  She wanted actual names.  Audio cable didn't seem to cut it with her!  You would think every computer would have a plug in for a headset & maybe this would work? Thanks for your help!

[Mary Beth]

First of all, good luck on your test.  

We can plug the DAI (direct audio input) cables into any headphone jack.  However, it is typically not recommended to use them with devices that are actually plugged into an outlet.  For safety reasons, those cables are usually recommended for battery operated devices.  The reason for this is the possibility of a power surge through the outlet, to the computer, through the cables to our processors.  I know people who do use those cables with devices that are plugged into outlets.  I do not.  I only use them with battery operated devices.

 

I have had great success with over the ear noise canceling headphones with my Sonnets.  Things sound awesome.  I had a BOSE Quiet Comfort set from when I used a HA and just tried it out one day with the Sonnets.  Works great.  You may be able to find an over the ear noise canceling headphone that works great for you and ask to bring it to the testing.

 

Other more complicated or expensive possibilities include:

-DM System (like Roger) with transmitter plugged into the headphone jack and receiver attached to your Sonnet

-BlueTooth streamer device plugged into the headphone jack and BlueTooth neckloop worn with processor on T (ClearSounds QLink and Artone TVB are examples)

-Connect via the computer's own BlueTooth to a BlueTooth neckloop.  Sometimes this requires firmware to be loaded into the computer.  Sometimes it just works easily.

 

Whichever tech you choose to use, it may be best to experiement with it ahead of time to ensure you like the sound quality.

 

Good luck!

[Travel]

Thanks, Mary Beth!  I haven't applied or scheduled the test yet.  Ran into this snag in getting ready to apply.  If they do make some type of accommodation, of course paperwork must be filled out by a doctor or rehab counselor stating that a disabling condition requires this accommodation.  Hmmm....was hoping the direct audio might work for me.  I don't think the entire test is audio -- just a portion.  Not really looking to go purchase anything new right now.  Unfortunately I was downsized from my job recently & am trying to keep my expenses at a bare minimum while looking for new employment.  Of course the relatively new cochlear implant has added an additional snag in looking for employment.  -- I have all of that bubbling around all speech I hear.  Hard not to get discouraged with everything going on.  I do have the Quattro neck loop but hear much better with the direct connect....and don't know if the Quattro could work with the computer anyway.  Still trying to learn about all of this cochlear implant stuff!  Anyone else have experience using the direct audio connect & think it would be safe to use for the testing & would it even work?  Thanks again.  All of you provide such helpful information!

[Mary Beth]

The direct audio input cable would work.  It works in any headphone jack.  It sounds great.

The bubbling around speech...... do you notice it at the word level or only at the phrase/sentence level?

[Mary Beth]

Link to assistive tech

 

http://s3.medel.com/pdf/US/fl-br/22871_30_Get+Connected+Brochure++USA++English.pdf

[Travel]

Thanks for the link.  I should be able to email the ADA woman at civil service that brochure so she can see exactly what I was referring to.  Very helpful.

In regard to the bubbling.... It seems to be at the word level as well as phrase/sentence level.  Of course, I notice it more at the phrase/sentence level since speech is longer there.  Sure wish someone could figure out that issue & give me & Richard723 some relief.  I am getting to the point that I dread putting my processor on in the morning & can't wait to take it off in the evening.  It's just so, so distracting & irritating.

 

[Mary Beth]

I'm thinking that I might be repeating myself here, so if I am please forgive me.

I just think your bubbling annoying sound should be able to be MAPped out.

Have you already asked for your regional CAM (Clinical Account Manager) to join in a MAPping appointment?

Has your audiologist reached out to Med-El's in house audiologists for ideas?

Have you thought about seeing a different clinical audiologist to see if she/he had other ideas?

There is a study at Vanderbilt called Image Guided Cochlear Implant Programming.  Several people have participated and shared their experiences.  Many reported a much cleaner speech sound.  If you are interested, reach out to Linsey Sunderhaus at Vanderbilt.  She is very nice.

i hope you find a solution to that sound quality that is interfering for you.

[Travel]

Mary Beth,

Thanks for all of your ideas.  Do you personally know of anyone who went to Vanderbilt for the study?  I started researching this online.  I found one document that actually had the comments made by the participants in the study and the vast majority were very positive. (of course I didn't bookmark it & now I can't find that particular document again!)  I would be at least 8 1/2 hrs away by car & it sounds like 3 visits may be required.  But honestly if I could get relief from this bubbling it would be worth it!  I did see a different audiologist & they also were unable to map out the bubbling.  This audiologist wondered if it might not be the hardware.

In regard to the Bose noise canceling headphones, I got on the Bose site & it says some are for Apple ipads, ipods, etc.  Others are for Android devices.  If you have a moment could you glance at the Bose site & tell me which ones you think would be compatible for computer use?  I've been speaking with my family & we just don't know that we feel comfortable with my plugging directly into the computer for safety purposes as you mention.  The way my luck has been....my insurance is changing next month & I have not gotten a good answer on coverage for my cochlear implant.  Just seems like I'm spinning my wheels on everything I try to do.  There is a Bose store not too far away & maybe I could try some headphones out in the store.

Always nice to correspond with you as you are always so encouraging & helpful.

[Mary Beth]

Hi Travel,

 

Yes I do know several people who participated in the image guided study at Vanderbilt. (Including me). If you check out the FB group

Med El Cochlear Implant Discussion Group

ask to join and an admin will add you (I am not an admin.)

then search in the group and you will be able to read many posts about that study from people who have or who are now participating in it.

 

For me, I was interested in participating in that study to see what changes would happen if my electrodes were not stimulating the same spot.  Basically that is what is done.  CT scan is used to make a 3-D model and put through their special software program.  They determine which electrodes ar overlapping and then recommend deactivating specific electrodes to reduce the overlap yet still provide full coverage.  I was performing very well with my CIs and enjoying music, etc before the study.  I was just curious to see what would happen if I was given such a MAP.  I love the changes and can't believe how different things sound.  I am choosing to remain in the research MAPs and my audiologist has made tweaks to one of those MAPs to even things out for me.

 

Other people enter the study with sound quality that they do not like.  Some of them notice an improvement in sound quality right away.  I believe I read that between 70-75% of study participants choose to stay in the research MAP.  That seemed encouraging to me since many of us do not like changes to our MAPs.  Smile.  Of course, that also means that between 25-30% don't prefer the research MAPs.

 

Don't base your decision just on my experience.  I am only one person.  Read other people's experiences and then decide if that is something that interests you.  There are many links to info on the study in that FB group I mentioned.  You will find a lot of info there to help you decide and you can throw out questions to the group.

 

My BOSE Quiet Comfort noise canceling headphones are old.  They are QC2 and I believe the new ones are QC35!  Smile.  I went to a BOSE store and tested headphones with my HA trying to find one that didn't cause feedback and sounded good.  I think this was back in 2000.  If you only want headphones for limited usage with a computer, you can find QC2 on eBay for much less money than a new set.

 

The audiologist who is wondering if your bubbling problem is a hardware problem......is she referring to your internal implant?  You have already switched out your Sonnet processor right?

 

Here is what I have learned about Med-El during my 2 years of being implanted.  They really want to help us get the most out of implants.  Don't settle for a compromised sound signal.  Keep asking questions.  Contact Med-El in house audiology.  Ask for help.  It really is like a Med-El family.  

 

I will ill send you a PM here (mail) and give you the general email for in house audiology.

 

I believe things can be improved.  Sometimes it is just difficult to figure out how to get things improved.  Smile.  Hang in there and keep seeking help for this bubbling sound.

 

One last thought........early on in my right CI journey I experienced a sound sensation that was difficult to describe when I was listening to people speak for awhile.  It was not noticeable at the word level or even the short sentence level, but it was noticeable and distracting when listening to longer speech.  The best way I could describe it was like someone hit a tympani drum and I didn't hear the note from the tympani just the wave like reverberations afterward.  My audiologist guided me well.  We gave the ear several months to see if my brain would just sort this out and when it didn't, we turned off an electrode.  The result was immediate.  Bye bye tympani like reverberations,  Now, interestingly enough, that electrode is back on in my research MAP but the neighboring one is off and no reverberation issue.  So these things all interact together in complex ways.  Sometimes it is trial and error to find a solution.

 

Which state are you in?  I forget.  I am in New York (near the Canadian and Vermont borders).

wishing you the best.

[Travel]

Wow sounds like you had great results from the study.  Really interesting.  How many times did you need to go to Vanderbilt?  Do you know how long it takes them to make the 3-D model & create the map after the CT Scan is performed?  Just wondering if the time could be cut from 3 visits that I read about online to 2 visits.  I definitely plan to investigate this further.  I've been very discouraged.  As I've mentioned before my testing results are great, but real world results are very disappointing especially with the bubbling.

[Mary Beth]

It's best for you to contact Vanderbilt directly and ask those questions.  I participated in several research studies there so my situation was a bit different.

 

[Adam]

Travel,

have you scheduled your test yet? Are you going to go with the over the ear headphone or DAI? Curious as to how that all played out.

[Travel]

Hi Adam,

Glad you are back & hopefully feeling much better.  My test is finally scheduled for next week.  I will be testing in a separate testing room & will be listening to the video/audio portion via the computer speakers rather than headphones.  If for some reason this is not clear, I have the option for DAI.

Thanks to everyone for your suggestions.

[Mary Beth]

Best of luck on your test!

[Cara Mia]

@Mary Beth

Thank you for your detailed post about the wonder at Vanderbuilt. I hope that over some period of time this practice will become a routine for all. Somehow we discussed that MAP ping is something that combines science, art, and even some kind of roulette (hopefully, not the Russian one ). I'd prefer this process to be handled mostly with scientific approach with all my respect to our audiologists' talent and intuition.

It is not that I am not a big fan of art. Pretty much otherwise. But you know, enjoying Picasso, or "The Black Square" by Malevich in museums does not mean you are happy to have such chef d' oeuvres in your living room. Or who wants to have Michelangelo's David in a master suit...

[Mary Beth]

@Cara Mia

From what I understand, Vanderbilt is hoping that this technology will be available to all of us.  Since it uses features that are already able to be set by our audiologists, it can be used by anyone.  Vanderbilt scientists recently received a grant to develop the software that can automatically determine which electrodes overlap.  I hope it is incorporated into CI programming software.  Then our clinical audiologists would be able to see which electrodes for each side are recommended to be turned off.  If people do not like that program, they can return to any other program they want.  70-75% of the research ears preferred the research program so if that remains constant between 25-30% of people will not prefer the image guided program.  In my opinion, it's worth testing out.  

[Adam]

Easier said than done @Cara Mia  In mapping or in the CI science when it comes to a patient, there are no absolutes as what is a perfect map for one might be terrible for another. Audiology is a lot like medicine as it is mostly an art in achieving a specific goal BUT you still have to have detailed and advanced knowledge of that particular specialty. The great ones can rely on intimate knowledge of the science while using experience and creativity to tackle challenging mapping situations.

your thoughts?

[Mary Beth]

@Cara Mia

 

check this out.  Scroll down to Benoit Dawant

 

https://engineering.vanderbilt.edu/news/2016/six-profs-attract-national-institutes-of-health-grants-for-wide-ranging-research/

[Mary Beth]

@Cara Mia

 

check this out.  Scroll down to Benoit Dawant

 

https://engineering.vanderbilt.edu/news/2016/six-profs-attract-national-institutes-of-health-grants-for-wide-ranging-research/

[Mary Beth]

@Cara Mia

 

you may may have seen this one already

 

http://www.karger.com/Article/FullText/365273

[Mary Beth]

Great info here

https://www.ncbi.nlm.nih.gov/pubmed/?term=Image+guided+cochlear+implant+programming

 

@Cara Mia

[Adam]

Travel, I need to take it slow. Have to be patient as you really can do anything for a fractured sternum except be careful and rest.

let us know how things go. We are rooting for you

[Cara Mia]

@Mary Beth

thank you for links. Will read tonight for sure when I get home. I hope you are right and this technology will be available for everybody who wants to try it. Agree, it will be an additional option for us with the possibility to stay with the conventional adjustment.

 

@Adam

In general I agree that Audiology is a complex "medicine". So, the more tools is has, the better results for us. So, science and art should stay

I believe that more objective information will help our audiologists to be more precise and, thus, successful with their intuitive art for our goods, especially in challenging situations.

I think the information gathered from scan can serve as a landmark, as a start point for the individualized comfortable hearing achieved faster with less efforts.

[Mary Beth]

@Cara Mia

Exactly what this clinical trial will test : standard practice versus image guided activation

 

https://clinicaltrials.gov/ct2/show/NCT02815124

[Adam]

Sounds like a plan. The best outcome possible is always the goal. Any help to achieve that should be utilized