How loud is loud?

[JohnNadashki]

Hi all,

I would like to know "how loud is loud" in terms of CI adjusting/programing purpose.

Let say whenever I visited the CI appointment, I was going through the process of "tunning" (I don't know how to call this, please name if I call it wrong) which I was listening to beep sounds while audiologist increased the volume's loudness of the beep (in each frequency band?) till I couldn't endure anymore. I was told to say "stop or too loud" when I can't stand it.

I am asking question of "how loud is loud" because I can tolerate the level of loudness till it is too loud caused pain inside my head.  In the other words, the process can be described in 3 levels such as 1/ the volume of loudness is increasing till I feel something is shocking/poking in my head, 2/ then it gradually becomes an uneasy feeling, 3/then it pains. When it caused pain, I then say "stop" it. When it is said "stop/too loud!", my Audi often turns the loudness level 1 step down (please notes: the loudness level 1/ and 2/ are still there). So, with 1 step down, the pain is gone but the poking/shocking is still there.

With the new setting (I guess, you call this is a "map", right?), I start to socialize, and I feel the poking/shocking happens very frequently during any conversation I have, and it becomes annoying. Therefore, I have to reduce the volume (using audiokey2 app) till I feel no poking.

I feel turning down the volume of loudness (using audiokey2 app) is defeated the whole purpose of "tunning", and I would make no progress.

So I have few questions:

1/ Would you share your experience of how you feel or decide "it is loud" in a, b, and c below:

• a/ it is loud but no poking/shocking (Loud)
• b/ it is loud with poking/shocking and can tolerate (too loud)
• c/ it is loud with poking and pain (Way too loud!)

2/ I am having the b/ above. Will that poking/shocking go away after a while?

 

My CI appointments take "few months" in between; thus, any input I have for Audi is important to make every visit is a successful visit. (I don't want to go back to previous stage ... So, I need to get it right!)

 

Thank you

Regards, 

John

[Mary Beth]

@JohnNadashki

Listening with our CI should be comfortable.  Sometimes during the early months of adjusting certain sounds take getting used to.  For me that was plates when unloading the dishwasher.

When we are getting a new program with our audiologist we aim for loud but comfortable.  There should not be any non auditory sensation and if that happens, it is important that we tell our audiologist when that happens.

It is common for new CI users to think that louder is better but in fact with CIs that is not the case.

Try to aim for loud but comfortable.  
 

This sets the maximum loudness our CI ever reaches no matter what situation we are in.  I can attend huge sports arenas with thousands of screaming fans and never have to lower my volume.  My loud but comfortable settings work great.

[JohnNadashki]

Thank you Mary!

It sounded like I should request to go back to 1a/

Thanks again

 

[Michael Shipman]

@JohnNadashkiMy audiologist takes a more relaxed and open-minded approach, telling me that there is no right or wrong answer when it comes to the loudness level. Once she turns on all the electrodes, she works with me to make adjustments and ensures that I feel comfortable.

[JohnNadashki]

Hi Michael,

Were you experiencing any a, b, or c?

So with [she works with me to make adjustments and ensures that I feel comfortable.], I guessed you only chose a/ or prior to a/

 

What I am trying to figure out if the feeling of poking/shocking is the max or 1 step above of max loudness level of setting that patient can take safely.

As I described above, I can tolerate the loudness with poking/shocking, but I cannot tolerate if the poking caused me a pain. I did describe to my Audi Dr. that I heard loud beep with poking, and I could tolerate it, then we continued to increase till I felt little pain, then we backed out ... I am not saying right or wrong here since my audiologist depends on my input, I am new CI, and I just don't know when "loud is loud enough". If I say "loud" too early, then I may have more follow up appointments. If I say "loud" too late, I will have annoying poking as I described. (As I am typing a reply to you now, I have increased the volume, and I felt less poking. It seems I get used to the loudness as I am progressing daily ... I hope all my rambling make sense to you)

So, as yours and Mary's responses, I should stay with a/

Thank you for your input!

 

[Lauren]

@JohnNadashki@Michael Shipman

My audiologist would remind me early on that I’m not to feel anything or have any sensations whatsoever.

If you reach A you should stop. B and C is way too much and your audiologist should walk the volume back down until you aren’t getting any sensation(s).

It’s called Most Comfortable Loudness (MCL) and as @Mary Beth stated, it should be comfortably loud but not overwhelming and zero physical sensation. 

You can try asking your audiologist for an eSRT test, if they have the equipment to do it. This is the volume test with the beeps but requires no input or feedback from you. I had this early on for my left ear back in 2021 but unfortunately got no measurable results so we have done volume adjustments the traditional way. My audiologist is game for trying with my right ear when possible and also re-trying my left to see if anything has changed in (roughly) three years. 

[Michael Shipman]

@JohnNadashki@Lauren

I haven't been able to hear out of my right ear for fifty years. Because of that, my audiologist is being very cautious during my visits to ensure my comfort. At each visit, she has been gradually increasing the volume, but I'm still not hearing within the normal range yet.  So, yes, “a”.

My second activation is approaching, and it will be different this time as I have been using a hearing aid in that ear for 44 years. I will share my experience with MCL after the activation.

I'm pleased to have come across this post to gain more insights into MCL and prepare myself for activation.

[JohnNadashki]

3 hours ago, Lauren said:

@JohnNadashki@Michael Shipman

My audiologist would remind me early on that I’m not to feel anything or have any sensations whatsoever.

If you reach A you should stop. B and C is way too much and your audiologist should walk the volume back down until you aren’t getting any sensation(s).

It’s called Most Comfortable Loudness (MCL) and as @Mary Beth stated, it should be comfortably loud but not overwhelming and zero physical sensation. 

You can try asking your audiologist for an eSRT test, if they have the equipment to do it. This is the volume test with the beeps but requires no input or feedback from you. I had this early on for my left ear back in 2021 but unfortunately got no measurable results so we have done volume adjustments the traditional way. My audiologist is game for trying with my right ear when possible and also re-trying my left to see if anything has changed in (roughly) three years. 

Hi again,

Lauren,

I had the tests twice, but I was not sure if they were eSRT test ("You can try asking your audiologist for an eSRT test"). Basically, Audi Dr. puts the tube/wire with ear plug to my right ear (I have CI in left ear) then put the rectangle soft pad in my right shoulder. All of these wires/tubes from that rectangle pad run to a machine that has a size of typewriter. Then I did not do anything but listen to the beep from soft to loud, then louder from that machine. Dr then stopped once in a while to adjust my CI electrode bands on different computer. Dr. tried in my right ear, then left ear with same ear plug, then concluded I had no response. To be specific, Dr. said my right ear drum vibrate so quickly and sent so many signals which made it almost impossible to catch the right signal that works for the map. Then we failed back to traditional test by listening for loud sound level.

I guess, in my case, I have to be really alert and have to be careful with what "loud sound" mean before giving Dr. the signal to move forward or stop.

Thank you for confirm the MCL!

 

 

[MarkRichards]

In my case it is about finding balance between my CI on one side and my hearing aid on the other.   I do my best with map process, as you describe, and use the AudioKey2 app to balance the volume with my hearing aid.