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MAPping appts - being able to give our audiologists feedback helps create better programs

Mary Beth

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What kind of feedback have you given your audiologist that helped create a better program for you?

I will tag a few members to get us started but would love to hear from everyone.





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Following the suggestion of “if it ain’t broke don’t fix it” my audiologist and I generally focus on what I don’t like, what isn’t going well, what I’m struggling with, what I’d like different, and other similar such items. 

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My audiologist and I follow much the same approach as Lauren. Now, after having been activated 9+ years (current using bilateral Rondo 2), I have annual visits with my audiologist but usually need only minor tweaking of my programs. 

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I have ears that present very different CI programming needs- yet the sides are very balanced in everyday listening.

My right side is a steady, easy CI programming side.  It uses the same program for years with no need for any adjustments.  An incredibly easy side.  (Which is surprising because this ear had not processed any sound at all for 24 years before being implanted, although it had heard to varying degrees before then).


My left side is tricky to MAP.  It has very unusual thresholds (the loudest sound that each electrode can be set and we do NOT hear anything).  This means that using Med-El default threshold settings (which is what most people use) does NOT work for my left ear.  My CI audiologist sets each electrode’s threshold level manually.  This made a HUGE difference.  BUT unfortunately my threshold levels fluctuate so every 5-8 months things sound off (too quiet and reduction in sound quality) which is not solved by just increasing the volume.  I need to return to my CI audiologist when that happens and we must manually set each threshold again and slightly adjust the most comfortable loudness levels.  Then everything is back on track until it happens again.  This is due to some fluctuating change in my cochlea- which is not Ménière’s.  Fortunately for me these changes go both ways- down and up- so I am not continually needing more power.  I just need some thresholds lowered and others raised every 5-8 months.  And I work with an awesome audiologist at New York Eye & Ear in NYC and she handles this beautifully.  My left side is an example of an ear that can not use Med-El default MAPping approaches.

Things that I report to my audiologist when we are tweaking a newly adjusted left MAP after manually setting each threshold again are….

- sound quality of both my voice and her voice 

- whether the MCL settings (most comfortable loudness) are equally loud.  For this I draw marks on a paper to reflect loudness levels as she plays those M beeps from lowest to highest.  When I look at the paper and see a horizontal line I know those beeps sounded the same loudness level to me.  If the line drops down, it represents a quieter volume.  If the line slants upward, it represents a louder volume.  Then we discuss it and my audiologist adjusts the M levels slightly to get things better balanced.  

- Then I listen with both sides together to see if everything sounds balanced once again.


This process of manually setting each threshold level and then loudness balancing the most comfortable loudness levels always brings my program back to sounding great again.  We usually use the IOWA test in her office for a quick way to check speech sounds.  (Search here for IOWA and I posted the test and how to do it.  You can do it at home with a family member anytime.)


So I have an incredibly easy to MAP right ear and a tricky to MAP left ear.  I am so thankful that I work with an outstanding audiologist who is skilled at MAPping beyond default approaches.  It is worth driving 5 hours each way to get to work with her.  The fact that she works in a very large, well respected CI center which serves many CI users definitely helps.  She programs MANY CIs.

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