My EAS Adventure

[Cara Mia]

I am going to switch to EAS on May 3rd. The first step was to made a custom earmold. That appointment took only 15 minutes. I was told that my processor I use now will be switched to EAS modification for free. And if I don't like EAS after trying, I will be able to exchange it back to a just CI processor at no cost. During my next appointment MED-EL CAM will assist my audiologist to activate and adjust my new EAS processor. 

Curious how the earmold will feel in my ear and, of course, how EAS will change the quality of my hearing (especially speech understanding and music perception).

The bad news, by that time there was no appointment scheduled for ASM 2 training with Med EL for my Ci center.

[Mary Beth]

Good luck!

[David]

@Cara Mia

Good luck, and also a question.

Are you using a Sonnet processor?

If so, I was under the impression that in addition to possible mapping changes and adding an earmold, the only other requirement is to use a green tip earhook with a hollow tube, instead of a closed end earhook. Is this incorrect?

[Cara Mia]

Thank you Mary Beth and David.

David, yes, I have Sonnet processor. Initially I was told that EAS functions are built-in into Sonnet and to use EAS I need to attach a hollow tube with earmold instead of earhook and get my processor reprogrammed.

It was Mary Beth who told me that this is different in reality. During my last appointment, my audi confirmed that our previous impression was incorrect - the regular Sonnet and Sonnet with EAS have different modifications.

[Mary Beth]

Sonnet and Sonnet EAS have different model numbers.

It may be possible to use a Sonnet EAS as just a CI but not necessarily the other way around.

[David]

@Cara Mia @Mary Beth

Thanks.

One of the questions I sent to Med-El during the past two days:

Were the two original Sonnet's I received in 2015, and/or the warranty replacements sent afterwards, also EAS enabled?

Excerpts from the response I received after posting my question to you, Cara Mia:

Your original Sonnet control units were not EAS units but any Sonnet processor could be converted to an EAS unit by simply replacing the regular ear hook with one of the EAS ear hook & hearing aid portion.  By the same token, any Sonnet EAS processor becomes a regular Sonnet processor by removing those items from the equation.

I mentioned several things concerning EAS in another post on this forum yesterday that clarifies my interest in this topic.  

[David]

@Cara Mia @Mary Beth

Thanks.

One of the questions I sent to Med-El during the past two days:

Were the two original Sonnet's I received in 2015, and/or the warranty replacements sent afterwards, also EAS enabled?

Excerpts from the response I received after posting my question to you, Cara Mia:

Your original Sonnet control units were not EAS units but any Sonnet processor could be converted to an EAS unit by simply replacing the regular ear hook with one of the EAS ear hook & hearing aid portion.  By the same token, any Sonnet EAS processor becomes a regular Sonnet processor by removing those items from the equation.

I mentioned several things concerning EAS in another post on this forum yesterday that clarifies my interest in this topic.  

[Mary Beth]

I wonder what the "and hearing aid portion" means?

[David]

Earmold.

[Mary Beth]

Maybe the "and hearing aid" portion is why Cara's Sonnet could not just become a Sonnet EAS by changing out the earhook.

[Mary Beth]

@Cara Mia

@David

 

Do you think the Sonnets we received prior to FDA approval were different from the Sonnets shipping now?  Cara Mia, needs to swap her Sonnet- not just attach the correct hook and add an earmold.

 

interesting

[Cara Mia]

That's confusing and interesting..... So initially (somewhere in February when we started discussing the possibility to switch to EAS), my Audi told me that all that I will need is to change earhook to earmold and reprogramming. In the middle of April, she told me that is should be the different processor and MedEl is ready to exchange it at no cost....

Will clarify this with her during my next visit. Actually, it makes no difference for me which processor I will use as EAS, but always good to understand how that things work and what cause such misinterpretation.

 

[David]

@Cara Mia

Apparently, exchanging the processor is unnecessary.

Adding the earmold and EAS earhook hopefully will improve your overall hearing experience, and I suppose mapping adjustments may also be required.

In either case, best wishes for success on your continuing journey.

[Mary Beth]

So David, lost in all of my confusion over the EAS....I forgot to ask you how things are going!

How are things going?

[David]

Mary Beth, thank you very much for asking.

Thing are just ok, but not as smooth at the first implant. This was anticipated, due to injuries sustained a long time.

 

[Mary Beth]

My CI journeys were very different from each other.  In the end, they balanced out very well.  I hope that happens for you too.

[David]

@Mary Beth

Thanks.

In the whole scheme of things, it's minutiae. When all is said and done, nothing will offset the benefits derived from hearing.

[Mary Beth]

 

Sonnet and Sonnet EAS clarification from our friend @leighf

"the SONNET and the SONNET EAS are basically the same processor with different technology built inside. For countries that offer EAS, SONNETs can be ordered with EAS technology built in, however a SONNET cannot be upgraded to EAS. "

 

So if we have a Sonnet CI, it can not turn into a Sonnet EAS just by changing the earhook, attaching an earmold and programming it differently because Sonnet CIs do not have the acoustic component built in. (This is why @Cara Mia had to have her Sonnet CI switched out for a Sonnet EAS.)

 

I believe if we have a Sonnet EAS, it can operate as either a Sonnet EAS or a Sonnet CI based on earhook, attaching or lack of earmold and programming BUT I am not sure of that.  Maybe Leigh can clarify that part for us. ( @David's comments make me think this is true.  Also because someone with a Sonnet EAS mentioned she had a program in her 4 choices that was only CI.  Whether we need to switch the earhook is unclear but David had better sound once he switched it.)

 

Lots to learn for sure.

 

 

[David]

@Mary Beth @Leigh

My interpretation of the EAS earhook information supplied by Med-El was all Sonnets sold since their Spring, 2015, availability in the United States incorporate the acoustic component (hardware, firmware, software, etc.) The earhook, plus dome or earmold, are all that's required to provide the feature.

As I did with my first implant, I now use the same audiologist for mapping, and same audiologist/speech pathologist for rehabilitation for my second implant. They are both highly qualified, and I saw both of them yesterday since my activation a week ago. They are part of the Hearing Rehabilitation and Cochlear Implant Program - Department of Otolaryngology - Head and Neck Surgery at The Washington University School of Medicine in St. Louis. I confirmed the following.

EAS must be specified at the time of order. My order was entered correctly, but shipped incorrectly.

The only thing required to implement EAS is the different earhook, which is the same requirement Cochlear's EAS version. Cochlear apparently has advised their clinics they can easily test patients with residual hearing by replacing the earhook to see if there is any difference, or improvement.

The bidirectional sound flow I described is common, as is disappearing interference when a standard earhook is used.

 

[Mary Beth]

I am glad you like the team you are working with David,  That is important.

Some of us have Sonnet CIs that are not Sonnet EAS.  Since I was never a candidate for an EAS, I am just curious of others' experiences.  Between HP, the FB group and PMs people are being told different info about the Sonnet EAS by their CI teams.  The only thing that is important, is that everyone gets the best hearing from their devices as possible,  Maybe things are a bit confusing right now in the US because the EAS has not been around long.  Some members in the FB group were actually involved in the clinical trials.

 

It is all fascinating to learn about.  Wishing you the best.

[Cara Mia]

Yesterday I switched my SonnetCI to SonnetEAS. For short - it works for me. I was not sure if I want to have something inside my ear again. But looks like I have no problem with the custom mold I got with my EAS. Today I wear it since 5 am and just don't feel it at all, like there is nothing inside my ear. Hope, it is going to be this way all the time.

I have absolutely no problem with environmental sounds - nothing discuss here. Speech sounds different. Definitely, I need some time to learn to be comfortable with this. But from the beginning I can understand people and use the phone just with this single processor. After appointment I spent some time in Seattle downtown  - a very populated and noisy place with a special acoustics  (a busy highway surrounded by skyscrapers). Despite all that noise I was surprised how easy and clearly I could understand my husband. Funny, but his voice sounds different for me ( I like it even more now). Actually, some other men's voices sounds different. Women's voices sound the same. I have some timing lag on EAS side as compare to another side. But my Audi told me that it will integrate and feel more balance over some period of time after I get used to processing the acoustic information. Actually, that lag almost disappear at the end of our appointment and I had it for a short period of time in the morning after I put processors on after night.

Unfortunately, my ears not so balanced as before. But nothing to be upset. I hope it will be reached during my next adjustment in June.

Unfortunately, new mapping has not brought back my ability to understand music. It is not so bad now, but still a big mess. And nobody can explain this my regress.

Regarding rehab, I was advised to spend some time training just my acoustic input along with working on EAS unilateral and mixed bilateral hearing.

It seems that EAS consumes my battery juice. Today, the standard battery lasted only 9 hours compare to almost 11 hrs I had before.

I got a new user manual for Sonnet (Me1310) and Sonnet EAS (Me1320). I cannot find the issue date of this manual. It marked as AW31902_3.0 (English US). It says that Sonnet has two variants Me1310 is "an audio processor that supports electrical stimulation only, while the second variant (product code Me1320) additionally features acoustic stimulation..."

To resolve my issue with overwhelming low frequencies I got two progressive maps with FS4 strategy and FS4-p strategy. So far it seems that FS4 works better for me.

[Mary Beth]

@Cara Mia

 

Thank you for taking the time to share your experience in so much detail.  I never even considered a lag time in acoustic processing but that definitely makes sense since that neural pathway has not been in use for awhile.  Fascinating.  I am glad the lag time issue is sorting itself out so quickly for you.  Your brain is going to be exhausted again for a bit.  Smile.

 

I guess it makes sense that male voices would be most impacted by EAS since it is the bass tones that are now acoustic.  It's quite romantic that you love your husband's new voice even more.  Smile.

 

Has music always been a problem for you with your CIs or is it just sounding worse now due to your recent change to EAS?

 

Maybe we should jointly create a helpful music aural rehab list.  We could start a new topic.  We have so much in our aural rehab topic for speech but not much in one place for music.  If people are interested in working together on that, I would join in.

 

Being balanced is important and when I went through the image guided research in Vanderbilt, it also threw my balance between R and L sides off.  My awesome audiologist has been able to get my image guided programs to be balanced once again and that is such a relief!  Being off balance R and L for 3.5 months seemed very long.  I've been balanced again now since the end of March and it feels so much better.  Hang in there.  I am sure your audiologist will get you balanced once again in time.

 

Wishing you the best as always.

[David]

@Mary Beth

Thanks, Mary Beth.

Yes, my team is terrific and, in my opinion, equally as important as the surgeon's skill.

 

[Mary Beth]

We need an excellent surgeon on operation day.  We need awesome audiologists from activation day onward.  Their skills make all the difference in how we learn to hear with our CIs.  I believe programming our CIs is both an art and a science.  Finding an awesome audiologist is a blessing.  I feel very fortunate and it's why I choose to drive 5 hours each way to work with her.  She has made all the difference for me.

[David]

@Mary Beth

Ditto!