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Speech processing strategies FS4 bs FS4p


Mary Beth

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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

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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.

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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".

 

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@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.

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@Mary Beth Super.  Thanks.

 

From page 1:

image.thumb.png.f41b893bc1ded8b7a047296a4c8962ac.png

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:

image.png.b4d90320af1d792c27cf959da14a8c9d.png

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."

 

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24 minutes ago, Tim said:

 

24 minutes ago, Tim said:

.

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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.

IMG_3375.jpeg

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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.

IMG_3376.jpeg

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Thanks for the detailed interpretation!  I'm going to go into my next appointment with a better plan for the 4 program.

 

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  • 2 weeks later...

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.

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@Enegra

Has your team ever tried using triphasic pulses for your MAP?

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@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.

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