FS4-P? Does this aid in music appreciation.

[Kilgary]

I was reading this blog post about “parallel stimulation” which Med-El calls FS4-p vs “sequential stimulation”, which Med-El calls FS4. They cite studies showing SSD patients prefer FS4-P as it gets them a little closer to the actual sound of music. Anyone here have experience with this?

I was just re-mapped with ABF on March 1st. I checked my audiologist’s notes and I see I currently have the traditional FS4 (sequential) coding. Should I request FS4-p at my next mapping session?  
 

https://blog.medel.pro/products-updates/cochlear-implant-parallel-stimulation/

[Tim]

I gave a FS4-p a try last year.  Seemed to give a rumble in the bass that muddied things more for me.

Wonder if it might have worked better for me if done earlier, done after ABF, or if I had given it more time.

[Mary Beth]

I tried both FS4 and FS4p and greatly preferred FS4.  I hear great full bass tones with FS4.

[John Schulz]

I use FS4 on both sides since it is the recommended option. There's lots of other things that can be tweaked for listening characteristics such as soft sounds, polling rate, etc.

I had my mapping redone on my right side yesterday since it was sounding like dog water to me. I got a 76% word and ~85% sound recognition score. My audiologist and I went through and normalized the frequencies as well as increasing the soft sound level to 8%. I got an 80% word and ~93% sound recognition score 10 minutes later 😂.Music also sounds much more vibrant and has a wider stage. I am still getting used to it since it is a pretty big change especially with the soft sounds being louder. I do wish Med-El would increase the polling rate of the processors to something like 24ksps (thousand samples per second) from ~13ksps which is the maximum on the newest implant iirc. Maybe @MED-EL Moderator can fact check this?

[Kilgary]

12 hours ago, Tim said:

I gave a FS4-p a try last year.  Seemed to give a rumble in the bass that muddied things more for me.

Wonder if it might have worked better for me if done earlier, done after ABF, or if I had given it more time.

Thanks. Sounds like I need to get my ABF map to settle (still sounds too deep) before experimenting with FS4-P. 

[Anthony Canada]

I went with FS4-P early on. When I compared it to FS4 it sounded a bit richer. I find the deep sounds from the lowest electrode to be a bit too much but my audiologist is wanting to go slow with changing it because she's happy with my overall performance. I progressively lost my hearing in both ears so I don't know about the SSD aspect. When I told them I thought voices didn't have the punch they should they changed my maplaw to 1000 and that change has added to my music enjoyment. You can have a different maplaw on different programs so it could be worth trying if you are feeling like music isn't where it should be. 

@John Schulz what was your soft sound level before?

 

[John Schulz]

1 minute ago, Anthony Canada said:

@John Schulz what was your soft sound level before?

0%. This is pretty standard procedure where 10% is the maximum most audiologists would be comfortable using I've been told.

[Anthony Canada]

1 minute ago, John Schulz said:

0%. This is pretty standard procedure where 10% is the maximum most audiologists would be comfortable using I've been told.

It is weird how SOP changes depending on where you are. Mine started at 8% and they said they seldom move it after they establish the bottom level in the first visit. At 0% could you hear any of the quiet things in life like sliding a coin in the table?

[John Schulz]

1 minute ago, Anthony Canada said:

It is weird how SOP changes depending on where you are. Mine started at 8% and they said they seldom move it after they establish the bottom level in the first visit. At 0% could you hear any of the quiet things in life like sliding a coin in the table?

I could hear it, yes. I think it also has changed over the years. I was born Deaf and have had bilateral CIs for 15+ years so my programs have been carried and tweaked since those early days. Things such as ANR and WNR didn't exist until relatively recently so setting the soft noise threshold to 0% may have been a technique to keep things comfortable for the user when the processing techniques weren't integrated yet. I'm surprised at how quickly I'm getting used to it but I think that's in large part thanks to ANR.

[Mary Beth]

I have my softest sounds measured and set individually.  It helped a lot on my left ear which has irregular impedance levels.

[MED-EL Moderator]

On 5/7/2024 at 4:02 PM, John Schulz said:

I use FS4 on both sides since it is the recommended option. There's lots of other things that can be tweaked for listening characteristics such as soft sounds, polling rate, etc.

I had my mapping redone on my right side yesterday since it was sounding like dog water to me. I got a 76% word and ~85% sound recognition score. My audiologist and I went through and normalized the frequencies as well as increasing the soft sound level to 8%. I got an 80% word and ~93% sound recognition score 10 minutes later 😂.Music also sounds much more vibrant and has a wider stage. I am still getting used to it since it is a pretty big change especially with the soft sounds being louder. I do wish Med-El would increase the polling rate of the processors to something like 24ksps (thousand samples per second) from ~13ksps which is the maximum on the newest implant iirc. Maybe @MED-EL Moderator can fact check this?

@John Schulz  thank you for tagging us. The stimulation rate of the system is different from one electrode channel to another, and changes according to the pulse duration of the charge, which is different for each user according to your fitting map and the electrode’s impedance.  The overall electrical stimulation rate can be up to 50,704 pulses per second.

Please let us know if this answers your question.

Kind Regards 

[John Schulz]

2 minutes ago, MED-EL Moderator said:

@John Schulz  thank you for tagging us. The stimulation rate of the system is different from one electrode channel to another, and changes according to the pulse duration of the charge, which is different for each user according to your fitting map and the electrode’s impedance.  The overall electrical stimulation rate can be up to 50,704 pulses per second.

Please let us know if this answers your question.

Kind Regards 

So with some assumptions like FS4-p and that each electrode has the same duration (even though they don't), the maximum firing rate for a single electrode is ~8800 pps? I know it's more complex than this but is this functionally accurate?

[MED-EL Moderator]

Hi @John Schulz, thanks for your question.

There are a lot of factors defining the stimulation rate for each channel. These are different from one user to the other so it can not be defined in that way.

Kind regards