Implant & switch-on

[Adam]

Richard

i have had other medical issues in the past in which it was hard to find the root cause. Sometimes they never found out why, but did find a solution. I'm sure you must be frustrated. I know I'd be. I guess we have to be patient. I'm sure and hoping that the doctors can figure out what the issue is, and SOON! 

Please keep us updated

 

[hadron]

Richard723/Travel,

Which coding strategy are you using? FSP, FS4 or FS4-P?

Have you tried each one?

[Richard723]

hadron:

 

I am not familiar with what your talking about but I am going to follow up with the Audioligist, and will let you know.

Thank you for making me aware of this.

[Travel]

Hadron,

The audiologist has never mentioned this.  Is one of them the standard for the Sonnet?  You would think since I've been trying to get relief from the bubbling noise all along, she would have tried everything possible, but who knows.  She finally said the bubbling was maybe just a matter of my perception.  But I have my doubts.  Wouldn't others besides Richard & myself be having the bubbling issue if it were just a matter of perception?  What is clarity like for all other users?  Does it just sound like clear speech? (no bubbling around it?)

 

 

[Adam]

travel,

this is a brief explanation of the coding strategy and how they work.

Med-El’s latest speech strategies have caused a lot of confusion because of the naming. People keep on mixing up the three of them, but what do they actually do, and what is the difference between them?

First of all, they all use a special version of CIS: Continuous Interleaved Sampling. CIS works like this: The sound signal entering the microphone gets split up into different frequency bands. The amplitude of the sound gets processed with all the sound processing magic consisting out of dynamic ranges, noise filtering and all that high tech stuff, until you’re left with the envelope of the processed sound.

The different electrodes are mapped to different frequency bands, usually the most apical electrode – the electrode deepest in the cochlea – is mapped to the lowest frequency, and the most basal electrode is mapped to the highest frequency.

Each “cycle”, the incoming sound gets processed, the correct electrode pulses get generated, and every electrode gets sequentially stimulated with the waveform calculated for that specific electrode.

FSP, the strategy out of which FS4 and FSP-4 have evolved, differs from CIS in that there are some virtual channels being made through a specifically shaped pulse that gets stimulated in a regular electrode, but which sounds like an “in-between electrode”.

On top of that, in FSP the low-frequency electrodes (up to 3) will be pulsed at the same rate of the low-frequency sound signal. This means that the rate at which the apical electrodes fire won’t be the same as the rate of the basal electrodes, instead it varies with the frequency of the sound. This is being called rate-coding.

The FS4 coding strategy differs from FSP in that up to 4 apical channels can be rate-coded.

In FS4-p, the “p” signifies that the rate coding can be fired in parallel on any 2 of the 4 rate-coded apical electrodes, while still trying to minimize channel interaction.

This rounds up this post. I hope it was as informative for you as it was fun for me to write. To read more about electrode placement and sound coding, 

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[Adam]

Travel, if you do not have or are losing confidence in your audiologist. You can request another.
there was a situation in the clinic where I go where one of my audiologist patients felt like he needed to change to a different Audi. 
I understand your situation goes much deeper and I believe you have had a number of people involved. 
I personally have not experienced the bubbling sound that you are referring to. I haven't heard of this before.

 

[Mary Beth]

I haven't experienced the bubbling sound either.

[Richard723]

Just wanted to report on what is going on right now as I said I would. I saw my surgeon on Friday last told him of my difficulty and he said that I should tell the audiologist that I wanted to have more satisfactory hearing without the bee buzzing so to speak in my left ear which I had implanted in early September 2016. He showed me cat scan of the electrode right after surgery that is taken to insure proper placement it was perfectly rounded in cochlear. What was amazing is my left ear hearing actually showed almost no difference in the audible level sounds as prior db level after surgery. I went to the audiologist on Monday yesterday the 27th and she worked with me and no longer to do I have the buzzing it so far is been helpful I sense I am hearing better without the interference. She said she had tried all previous strategies but yesterday seems good now as we worked hard and she made some small changes and I am now much more positive than ever. The buzzing was really even physically tiring to me let alone my hearing nerves. It was like a VERY BASE or low sounding in effect its now gone.

Richard 

[Kara of Canada]

This is amazing news Richard! Or processors are so flexible and there is so much room for improvement! Thanks for the update!! 

[Adam]

That is so AWESOME!!! So happy for you!!! 

[Mary Beth]

Awesome news Richard!

[Travel]

Richard (My fellow Bee Keeper!),

I had been thinking about you & wondering how your appointment went. I AM SO EXCITED FOR YOU!!  It has to be such a relief!  Did your audiologist tell you which strategy she used this time that was successful?  Since my bubbling & bee buzzing continues....I'd be curious to know which strategy you ended up with.  Of course, I am always looking for any clues that might be helpful in trying to resolve my similar issue.  Was it a base electrode adjustment that seemed to help?  Now that your bubbling & buzzing is gone, I'm sure you will notice great improvement going forward.  Best Wishes & I'm so happy for you!

[Adam]

Maybe both your audiologists can compare notes. Your only issue would be patient concent

[Adam]

Maybe both your audiologists can compare notes. Your only issue would be patient concent

[Richard723]

Hi Adam:You make an excellent point for Travel all I can say I would more than willing to ask my audiologist to communicate with Travels Audiologist.

All I can say is I believe she left 10-11-12 off as before and said to me lets start from beginning with mapping once she did that the bubbling and bee base low interference went away. Before she did this she said I have used all the strategies I know, as the surgeon told me he wanted her to try a different strategy so I would be more satisfied with the result. I asked my surgeon if the implant might not have been properly in place he proceeded to show me either the x-ray or cat scan they took as soon as the surgery was finished in other words I was still out. It was perfectly rounded in the cochlear. 

 

When I went to audiologist I asked her if it might not be a faulty electrode, she immediately said no absolutely I would be getting a different reaction not bubbling or base sounding. Well back to what she did she turned down the volume as I said it was just to high and we spent some time with re mapping as to what she did exactly I have no clue she was pressing the keys on the laptop and kept asking how does that sound now it been almost a total transformation to me.

What was interesting the Dr. asked that I show copies of my hearing test to her from last May and the one done at my last appointment with him on the 24th of March this year and he can see that my hearing level in my left ear where the CI was done in September of last year is about 99% the same. She said she had never seen anything like that usually you lose almost 100%. She said I would like you just for curiosity sake is to use the hearing aid and see what happens, not to of course wear it but just to see what happens. 

Roughtly 4 months ago I had my hearing aid audiologist change my left hearing aid BTE to right side as a backup. Now my appointment just made today is April 5 to reverse that and re program for the left. I will let everyone know what if anything it does.

I feel confident my audiologist who is so nice would be willing to speak to travels but I can't speak for her of course. I am stil of course on this hearing  journey but i do feel I am now on the right track. Isn't all of life a journey as well.

Travel please let know what you would like me to do. I want to help. My best to everyone.

 

Richard

 

 

 

 

 

[Mary Beth]

Richard,

You may want to ask your audiologist if you would fit the parameters for the Sonnet EAS processor, which is a hybrid CI and HA and allows you to use your residual hearing.  Just a thought.

[Adam]

Richard

im glad you finally are making headway. I know how frustrating it can be having a problem but nothing or no specific test seems to be giving any answers. 

This isn't CI related but along the same lines. If you don't want to be bored, skip to below. In 2003 I got VERY ill all with symptoms stomach related. Couldn't eat, sleeping all the time, headaches. Yet every test run on me came up negative. The doctor that had taken out my appendix almost a year earlier put me in the hospital for 5 days running every test you can think. By this time we were 2 months in and no answers. I was down to 128 pounds. They then sent me to my neurosurgeon to run a battery of tests to see if the shunt in my brain ( for hydrocephalus) was working, even though I wasn't experiencing "typical" symptoms. They even drew some spinal fluid from my head to test for infection. Everything looked beautiful. The guaranteed me it wasn't the shunt but said that they keep the fluid on culture for 2 weeks to see if anything was growing. They advised me to see a stomach specialist and sent me on my way. After a week, I nosedived for the worse. I went back to see my doc. 2 weeks to the day later. Turns out I had a brain infection and they had to do emergency surgery. I spent 10 days in the hospital getting very strong antibiotics then had another brain surgery to place another shunt.

although that was scary as heck, while talking to my wife, we were so relieved as now we knew a course of action to take. I really thought, no pun intended, it was all in my head. There was such a relief having a plan and knowing you aren't crazy.

i had a real problem with electrode 12 after the first activation. We ended up turning it off for a while as some higher pitches were almost painful. We waited a few mappings, then turned it on LOW and slowly each visit brought the volume up until it was where we felt it should be. Took some time but it did work out.

my apologies for writing a book

[Richard723]

Hi Travel Adam & Cara Beth;

 

I am sorry I have been out of touch with everyone for awhile. I have to tell you I am still having a lot of difficulty with the Buzzing bubble sound like you Travel. When I went to the surgeon he said tell the audiologist to give you a more satisfactory sound. When I went back to her she said Richard I have done everything n my power nothing more I can do for you.

Just last week I went back to surgeon and he said sorry your one out of the 10% which this does not work for. Its works for 90%. They tell me its me and I said isn't it possible ts the electrode. Originally dDr told me I had good nerves before and after surgery and now he says maybe some of them are not so good at thats why your having issues. I am at my wits end and totally frustrated I feel like they have made me a hopeless case. The buzz is intense that it I believe it totally interferes with my ability to hear.

 

Any thoughts please share.

 

Richard 

[Mary Beth]

Have you asked your clinical audiologist to schedule an appt when your regional Med-El CAM (clinical account manager) can attend?  Also you can seek out a second opinion on your MAP at a large CI center with lots of experience with Med-El implants.

[Richard723]

Hi Mary Beth:

Thank you for your response. I have had my left ear implant just over 9 months right now and after around 4 months my audiologist did have the representative one day when I was there go over my issue, however the result was there was no change to the buzzing which continues to be my problem. You have good thought I would be more than happy to try a large CI center as you suggest. How do you go about researching to find one via the internet or other means.The nearest metropolitan area to me is Philadelphia PA.

[Mary Beth]

That is a great question and unfortunately I do not know the answer.  Definitely joining a Med El user FB group would give you access to many Med El users do you could post your question about great audiologists near Philadelphia there and people may share some recommendations.

 

check out

 

Med El Cochlear Implant Discussion Group (on FaceBook)

 

It is not an official Med -El group.  It is just users.

 

 

[Richard723]

Hi Everyone:

Unfortunately, my surgeon has old me that my implant probably won't ever work as 90% of people do fine with the cochlear Implant but I am in the 10% who it will not be effective. Travel its is very discouraging as we seem to have same issue of the buzzing bee type sound and Doctor tells me even though my nerves look good from cat scan and he originally told me I should have good results there is another issue that can't be seen or diagnosed and that is some remaining nerves are just not working with brain or in effect a disconnect and I will never be able to have even fair hearing again, something I will have to live with according to him. 

 

[Richard723]

Hi Everyone:

Unfortunately, my surgeon has old me that my implant probably won't ever work as 90% of people do fine with the cochlear Implant but I am in the 10% who it will not be effective. Travel its is very discouraging as we seem to have same issue of the buzzing bee type sound and Doctor tells me even though my nerves look good from cat scan and he originally told me I should have good results there is another issue that can't be seen or diagnosed and that is some remaining nerves are just not working with brain or in effect a disconnect and I will never be able to have even fair hearing again, something I will have to live with according to him. 

 

[Mary Beth]

Richard,

 

I am not a doctor and do not know your medical history.  But if it was me, I would seek out a second opinion at a large CI center with audiologists who have lots of experience MAPping Med-El processors.  You have nothing to lose in my opinion.  I am so sorry you have been told this and hope very much that possibly someone else can help you with the buzzing sounds.  Again, I am very sorry.