HearPeers Heroes Mary Beth Posted May 11, 2023 HearPeers Heroes Report Share Posted May 11, 2023 Our audiologists set each of our programs to a specific speech processing strategy. For most of us, it will be FS4 as that is the default. After reaching a stable MAP I tried FS4p as well. It wasn’t a good match for me as I hear bass tones well in FS4 and FS4p made things too bassy. But this article suggests that single sided deaf CI users tend to prefer FS4p. So it may be worth asking for a program in FS4p to see which one you prefer. https://blog.medel.pro/products-updates/cochlear-implant-parallel-stimulation/ @Kylie @Jared Charney @Tim Kylie and Jared Charney 2 Quote Link to comment Share on other sites More sharing options...
Members Tim Posted May 11, 2023 Members Report Share Posted May 11, 2023 Interesting and dense article. Thanks! My main programs are using FS4 but I think I have FS4p for one of my Rondo programs. It doesn't seem helpful for me so far but maybe I need to give it more time to try out. Even after going through the article, I'm a little confused. As I understand it, they seem to use the terms simultaneous and parallel to describe the same thing. The "p" in FS4p refers to stimulating 2 or more of the 12 electrodes at the same time. When this is done, there is opportunity for signals to "build up" between electrodes in unintended ways. The "intelligent" system that Med-El has developed adjusts for this. Something to talk about with my Audiologist in my Summer appointment. Dianna 1 Quote Link to comment Share on other sites More sharing options...
Members Tim Posted May 12, 2023 Members Report Share Posted May 12, 2023 My audiologist kindly sent me a PDF of the report and I would like to be able to do a better job decoding it. I think I understand about half of it. Is there a guide for how to read the Med-El Configuration Report? I know it isn't targeted for patients and I couldn't find anything looking around the MedEl site. Also, I wonder if it might be better to start off with FS4-p earlier in rehab rather than trying to re-adapt later in the process. It does feel/sound a little "bassy" with FS4-p but overall similar intelligibility. Perhaps the map could be tailored a little more to account for bass. After all, the original Med-El report says "the FS4-p coding strategy can provide enhanced temporal stimulation in the apical region responsible for low frequencies (from 70 to 950 Hz". Quote Link to comment Share on other sites More sharing options...
HearPeers Heroes Mary Beth Posted May 12, 2023 Author HearPeers Heroes Report Share Posted May 12, 2023 @Tim I have copies of my Med-El configuration report. If you take pics of the abbreviations or symbols you want help with, I will do my best. Quote Link to comment Share on other sites More sharing options...
Members Tim Posted May 12, 2023 Members Report Share Posted May 12, 2023 @Mary Beth Super. Thanks. From page 1: Some questions from page 1: Does Volume column have any meaning here? Is Map (10) vs. Map (11) and Map (12) refer to using different Mappings that have been done for me? (Ex. let's bump this electrodes up or down a little.) What does 12(4) Logarithmic mean? (Perhaps 12 refers to active electrodes?) Does "V: 75 (70-100)" refer to the starting volume and range? (i.e. program 4 has more range, this was done to accommodate the recommendation for Omni-microphone.) From Page 4: Most of these terms are well-defined and explained on Medel's website. Questions from pg. 4 Does "Default Sensitivity" refer to microphone? What does 0% mean in this context (is it really off?) What does "Compression Ratio" mean here? ------------------ Programs 3 and 4 were my attempts to get something for experimenting with omni microphone and using under the headphones for rehab. It seems they are identical other than volume ranges and MAP (11) vs. (12). Seems to defeat the purpose of testing omni-mic for me to have sensitivity set to 0%. My inclination is to try the FS4-p in a future program 3 or 4 slot with the general settings of Mild Adaptive Intelligence which has been my most used program. Happy to get any other ideas or suggestions. I have to wait 2 months for my next Audiologist appointment but want to make it count since it will likely be 6 months for the one after that. By the way, my Audiologist read Med-El's white paper and is open to more experimenting with FS4-p for me but says that she has "...not seen tremendous success in that program thus far." Quote Link to comment Share on other sites More sharing options...
HearPeers Heroes Mary Beth Posted May 12, 2023 Author HearPeers Heroes Report Share Posted May 12, 2023 24 minutes ago, Tim said: 24 minutes ago, Tim said: . Quote Link to comment Share on other sites More sharing options...
HearPeers Heroes Mary Beth Posted May 12, 2023 Author HearPeers Heroes Report Share Posted May 12, 2023 Position is program slots 1-4 on the processor. Map (#) is the program created by your audiologist. You see 2 programs both numbered 10 because you have the same Map in two different mic settings as you see later on. FS4 and FS4p are the two types of speech processing you have. As I mentioned before I tried FS4p but it isn’t a good match for me because it is too bass heavy. 12(4) denotes 12 electrodes being used in the Map of which 4 are rate coded. “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.” https://silenceamidstsound.wordpress.com/2014/12/19/med-el-speech-processing-strategies-fsp-fs4-fs4-p/ 70-8500 is your frequency range (which is Med-El’s present default setting) Volume V 90 (80-100) means your Map’s default volume is 90% and you have the ability to lower to 80% or increase to 100% with the remotes. Tim and Michi 2 Quote Link to comment Share on other sites More sharing options...
HearPeers Heroes Mary Beth Posted May 12, 2023 Author HearPeers Heroes Report Share Posted May 12, 2023 Program 1 is set to adaptive intelligence mild Compression rate 3:1 is default Sensitivity is at 75% (typical setting for that) Program 2 is set to Adaptive intelligence strong Compression rate 3:1 is default Sensitivity is at 75% (typical setting for that) This is why you see program slots 1 & 2 both using Map (10). They are the same Maps but set to different mic settings. Program 3 is set to omni with all front end features turned off Only unusual thing is the sensitivity is set to 0%. My omni programs use sensitivity at 75%. A zero sensitivity setting puts you in a very tiny sound bubble. Program 4 is also set to omni with all front end features turned off Only unusual thing is the sensitivity is set to 0%. My omni programs use sensitivity at 75%. A zero sensitivity setting puts you in a very tiny sound bubble. Quote Link to comment Share on other sites More sharing options...
HearPeers Heroes Mary Beth Posted May 12, 2023 Author HearPeers Heroes Report Share Posted May 12, 2023 This link has information about rate coding https://www.medel.com/en-us/hearing-solutions/cochlear-implants/closest-to-natural-hearing/?mtm_campaign=CtnH-US-Search-B2C&mtm_source=google-ads&mtm_medium=cpc&gclid=CjwKCAjwx_eiBhBGEiwA15gLNw1-da8nS0I6Fu8CTJQvr21v9UOHZFjEcSjHisj4MIuMGfIkUqdtihoC4h0QAvD_BwE Michi 1 Quote Link to comment Share on other sites More sharing options...
Members Tim Posted May 13, 2023 Members Report Share Posted May 13, 2023 Thanks for the detailed interpretation! I'm going to go into my next appointment with a better plan for the 4 program. Dianna 1 Quote Link to comment Share on other sites More sharing options...
Enegra Posted May 25, 2023 Report Share Posted May 25, 2023 I have FS4-p. After I went bilateral one day I found out that overnight both my maps went crazy. Especially the left ear was really bad and all the bass in it was... hollow. At the clinic they initially tried to just bring the MCLs higher on the lowest channels, but no matter how high they were, it still sounded like complete crap. With the FS4-p it finally started sounding normal again, the lowest two channels are still a bit higher than the rest, but not excessively. The battery drain is better than when the clinic tried to fix it by raising the volume. Quote Link to comment Share on other sites More sharing options...
HearPeers Heroes Mary Beth Posted May 25, 2023 Author HearPeers Heroes Report Share Posted May 25, 2023 @Enegra Has your team ever tried using triphasic pulses for your MAP? Quote Link to comment Share on other sites More sharing options...
Enegra Posted May 27, 2023 Report Share Posted May 27, 2023 @Mary Beth Just very briefly, to address my trigeminal nerve issues. It didn't help though, so I dropped using that map, as my original one sounded better. Mary Beth 1 Quote Link to comment Share on other sites More sharing options...
TechnoMonoCo Posted August 26, 2023 Report Share Posted August 26, 2023 I was activated yesterday (SSD) and to demo FS4 and FS4-p, my audi put two mappings with both to see what works best for me. I've mostly been using FS4-p with slightly higher volume (5% difference) and to me, seems the -p is more crisp, making it a bit easier to pick up on sounds I struggled with even with my good ear. Considering on my next mapping (Sept 8th) to have 4 FS4-p, one with no AI, one with mild, one with strong, and then the last one swapping from whatever my current mic mode (I think it's "natural"?) to Omni to see what the difference is there (using mild to have a stationary comparison). Tim and Dianna 2 Quote Link to comment Share on other sites More sharing options...
HearPeers Heroes Mary Beth Posted August 26, 2023 Author HearPeers Heroes Report Share Posted August 26, 2023 @TechnoMonoCo Make you you listen to the Omni mic program while you are there as a volume difference is reported often. It’s my favorite mic setting. Which CI center do you go to? I go to NY Eye and Ear of Mount Sinai in NYC TechnoMonoCo and Michi 2 Quote Link to comment Share on other sites More sharing options...
TechnoMonoCo Posted August 27, 2023 Report Share Posted August 27, 2023 18 hours ago, Mary Beth said: @TechnoMonoCo Make you you listen to the Omni mic program while you are there as a volume difference is reported often. It’s my favorite mic setting. Which CI center do you go to? I go to NY Eye and Ear of Mount Sinai in NYC University of Iowa, Hospitals and Clinics. Dianna 1 Quote Link to comment Share on other sites More sharing options...
HearPeers Heroes Mary Beth Posted August 27, 2023 Author HearPeers Heroes Report Share Posted August 27, 2023 @Dianna we have another Iowa member! Dianna 1 Quote Link to comment Share on other sites More sharing options...
Members Tim Posted August 27, 2023 Members Report Share Posted August 27, 2023 @TechnoMonoCo Glad that you are getting better results with FS4-p at activation. Nice plan of just trying those two stimulations. I wish that I had thought to ask about that at activation. Three months later and I was probably too adapted to regular FS4. I gave it a week as a trial but just couldn't get it to work well for me. Dianna and TechnoMonoCo 1 1 Quote Link to comment Share on other sites More sharing options...
Enegra Posted August 28, 2023 Report Share Posted August 28, 2023 @Tim It's possible it was just not a good fit for you, regardless of the time after activation. I know of some users of the blue brand who were activated using paired stimulation and decided to change to sequential after some time and liked it better. I've heard in the clinic that usually only young people like the paired stimulation, but since I lost trust in that place, I am going to take it with a big grain of salt. Quote Link to comment Share on other sites More sharing options...
HearPeers Heroes Mary Beth Posted August 28, 2023 Author HearPeers Heroes Report Share Posted August 28, 2023 Correct. And if more users preferred FS4p, I would think it would’ve become the default. There must be a reason that FS4 remains the default. Quote Link to comment Share on other sites More sharing options...
Dianna Posted August 28, 2023 Report Share Posted August 28, 2023 22 hours ago, Mary Beth said: @Dianna we have another Iowa member! Coool, just now saw!! Quote Link to comment Share on other sites More sharing options...
Dianna Posted August 28, 2023 Report Share Posted August 28, 2023 On 5/11/2023 at 8:11 AM, Mary Beth said: Our audiologists set each of our programs to a specific speech processing strategy. For most of us, it will be FS4 as that is the default. After reaching a stable MAP I tried FS4p as well. It wasn’t a good match for me as I hear bass tones well in FS4 and FS4p made things too bassy. But this article suggests that single sided deaf CI users tend to prefer FS4p. So it may be worth asking for a program in FS4p to see which one you prefer. https://blog.medel.pro/products-updates/cochlear-implant-parallel-stimulation/ @Kylie @Jared Charney @Tim I need to try this. I should have an upcomming 24 mo testing. I will check with my audi. I just lost my eas plug, then my spare batteries. ( lots of visitors this summer) so i just now requested plug replacement, and inquired on 24 mo research. We have yet another sister visit in september. Maybe i should wait to see if i lose anything else. I just checked my visit notes and dont see this FS4 or FS4 P in my notes, will review again. My audi is at U OF I and they program all three brands so sometimes specific medel questions i am sent to the rep for. Secretly i think my requests after hearing on HP are not always usual. Quote Link to comment Share on other sites More sharing options...
Dianna Posted August 28, 2023 Report Share Posted August 28, 2023 On 8/26/2023 at 2:00 PM, TechnoMonoCo said: I was activated yesterday (SSD) and to demo FS4 and FS4-p, my audi put two mappings with both to see what works best for me. I've mostly been using FS4-p with slightly higher volume (5% difference) and to me, seems the -p is more crisp, making it a bit easier to pick up on sounds I struggled with even with my good ear. Considering on my next mapping (Sept 8th) to have 4 FS4-p, one with no AI, one with mild, one with strong, and then the last one swapping from whatever my current mic mode (I think it's "natural"?) to Omni to see what the difference is there (using mild to have a stationary comparison). Hi there! I go to UI also!!!! Who is your audi may i ask?? Also have you attended any medel demo meetings? I missed the last one!!! Hoping for another after school starts! I was activated sept 10 2021, funny! TechnoMonoCo 1 Quote Link to comment Share on other sites More sharing options...
Dianna Posted August 28, 2023 Report Share Posted August 28, 2023 3 hours ago, Mary Beth said: Correct. And if more users preferred FS4p, I would think it would’ve become the default. There must be a reason that FS4 remains the default. Mary beth, im not aware of this setting so no choices were made. Remember it took me a few requests and the med el rep to get my sonnet synced, plus the omni setting because im getting "standard" and "common" settings, lol. Love omni no AI MAP! Mary Beth 1 Quote Link to comment Share on other sites More sharing options...
TechnoMonoCo Posted August 28, 2023 Report Share Posted August 28, 2023 25 minutes ago, Dianna said: Hi there! I go to UI also!!!! Who is your audi may i ask?? Also have you attended any medel demo meetings? I missed the last one!!! Hoping for another after school starts! I was activated sept 10 2021, funny! Lisa I haven't been to any demos yet - I just got activated on Friday, so I'm still getting into all of it. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.