February HearPeers Chat on GoogleMeet

[ats169]

@Mary Beth I am unable to find the International Forum that you mentioned, for tagging the med-el admin. Hope you can give me a nudge in the right direction -- thanks!

[Mary Beth]

@ats169

This is the international HearPeers forum!  Smile

[Mary Beth]

Timing is everything!  We just spoke about Dr Limb’s research at UCSF.

 

[Mary Beth]

@John R shared features he likes in the Roger Select transmitter.

below is a link to how Roger Select uses its three mics and beam forming technology.

 

remember that all Roger use requires both a Roger transmitter (Select, Pen, Clip on, Table top) and receiver (Sonnet Roger 21 battery cover, Roger X (02) attached via the 3 prong plug and set to the specific device, Roger MyLink neckloop with processor on MT or T).

[Jared Charney]

@John Rany suggestions for what to look for/at/etc when I go for my next mapping? thanks and also you might have already covered this but what do you find provides the best sound to your CI? I might try something else other than the AudioLink etc, cheers!

[Mary Beth]

@Jared Charney

Sonnet 2????

technically best sound may still be the direct audio input cables (DAI) plugged into the FM battery door (has 3 holes/Euro plug on the bottom) with the red jack cable (mixes 90/10) because cabled audio sounds better than BT or other 2.4 systems BUT not many people want to use cables.

 

@Justin really likes the audio quality of AudioStream

 

The audio quality of BOSE QC35 BT (with optional cable if desired) headphones is impressive. And works with an acoustic ear as well.

 

For ease of use and comfort, I choose to use Artone BT neckloop every day.

[Jared Charney]

 I'm mostly still using my Sonnet 2 over my Rondo 3 ( don't trust myself w/the Rondo 3 yet) I don't mind using cables will do so I seem to have lost the one it came with but will look again. do you know if the AudioStream is available yet to purchase? I actually have and use those Bose headphones and actually my cousin works for them and I had sent him one of our threads about how many people with CI's like this unit which he was very fascinated to learn of. I might try the Artone as well thanks!@

[Mary Beth]

@Jared Charney

Cool about your cousin working for BOSE.  I love their QC line.  My first one was QC2!  Yup TWO.  Smile.

 

The Artone will work with both your Sonnet2 and Rondo 3 (with its telecoil adapter) but it will not work with your acoustic ear.

The AudioStream will work with only your Sonnet2.  
 

Med-El US said that the AudioStream will be available for purchase.  They did not announce when, nor the price.

[John R]

3 hours ago, Jared Charney said:

@John Rany suggestions for what to look for/at/etc when I go for my next mapping? thanks and also you might have already covered this but what do you find provides the best sound to your CI? I might try something else other than the AudioLink etc, cheers!

Would you like to get together over a call?

 

[John R]

3 hours ago, Jared Charney said:

 I'm mostly still using my Sonnet 2 over my Rondo 3 ( don't trust myself w/the Rondo 3 yet) I don't mind using cables will do so I seem to have lost the one it came with but will look again. do you know if the AudioStream is available yet to purchase? I actually have and use those Bose headphones and actually my cousin works for them and I had sent him one of our threads about how many people with CI's like this unit which he was very fascinated to learn of. I might try the Artone as well thanks!@

@Jared Charney I was playing around with this set up last night. doing an A/B happy to talk results anytime. 

[Mary Beth]

@John R

If you are willing, posting your pro/con lists for these connectivity options here may allow others to join in the conversation too.

It looks like you have:

AudioStream for Sonnet 2/Sonnet 1

Roger Pen & Roger Select transmitters with Roger 21 Sonnet 2/Sonnet 1 receiver 

AudioLink for Sonnet 2/Sonnet 1/Rondo 3

 

I would be interested in your pro/con lists as well as your experience with the AudioKey2 app.

[John R]

1 hour ago, Mary Beth said:

@John R

If you are willing, posting your pro/con lists for these connectivity options here may allow others to join in the conversation too.

It looks like you have:

AudioStream for Sonnet 2/Sonnet 1

Roger Pen & Roger Select transmitters with Roger 21 Sonnet 2/Sonnet 1 receiver 

AudioLink for Sonnet 2/Sonnet 1/Rondo 3

 

I would be interested in your pro/con lists as well as your experience with the AudioKey2 app.

yes to all of the above as well as a few other toys.

Roger Select, by far the better "Sound Quality" for music streaming ( Only when connected to the Dock )  and I love its multiple microphones for group conversation EG: a dining table / board room.

Roger Pen does stream Audio through its Dock Also but not to the quality that the "Select" does. But then the Pen does connect both my CI and HA to my phone brilliantly and easily. 

as @Jared Charney was saying the Audio Stream is nice quality. and easy to use, but it does require the Apps and only goes to the CI not the HA. ( fine if you are Bilateral ) but still no Microphone so you do need to hold the phone close for phone calls, so not completly "hands Free" 
I find the Audio Link clumsy and poor reception distance compared to the others. how ever its Pro's are many.
the Multiple controls and options Mic On/Off, Stream with Mic On / Off Volume, and it does have an Audio In which means you do not always need the dock. 
Sadly there is a benefit for each device in a different application. I have not found a One device does all ( Well ) at this point. 

[Jared Charney]

2 hours ago, John R said:

Would you like to get together over a call?

 

would love that thanks John!

[Mary Beth]

@John R

Have you tried using the BT connection on the Select with your phone?  It should work the same way as the Pen for  BT connections

[Mary Beth]

@John R talked about frequency allocation per each electrode and many of us were interested in that.  It is part of anatomy based fitting.

I think it’s fascinating that John’s CI team may be using anatomy based fitting with his MAPping.  That is not yet available in the US due to FDA approvals.  It requires OTOPLAN 3 and Maestro 9 fitting software.  We are still waiting on Maestro 9 approval in the US.

 

@John R did you have a CT scan of your cochlea before and also after your implant surgery?

 

Here is a link to a Med-El post explaining that anatomy based fitting (frequency alignment based on electrode location in our unique cochleas) works with all internal Med-El implants.  It works with the newest generation of processors (Sonnet 2 and Rondo 3) which have the newest computer chip.

Exciting times!

Keep us posted on your experience John! 

[John R]

32 minutes ago, Mary Beth said:

@John R talked about frequency allocation per each electrode and many of us were interested in that.  It is part of anatomy based fitting.

I think it’s fascinating that John’s CI team may be using anatomy based fitting with his MAPping.  That is not yet available in the US due to FDA approvals.  It requires OTOPLAN 3 and Maestro 9 fitting software.  We are still waiting on Maestro 9 approval in the US.

 

@John R did you have a CT scan of your cochlea before and also after your implant surgery?

 

Here is a link to a Med-El post explaining that anatomy based fitting (frequency alignment based on electrode location in our unique cochleas) works with all internal Med-El implants.  It works with the newest generation of processors (Sonnet 2 and Rondo 3) which have the newest computer chip.

Exciting times!

Keep us posted on your experience John! 

Before and after 

watch my last Vlog episode. I actually got to video going in for it.

 

late here can elaborate tomorrow 

zzz

[Mary Beth]

@John R

Just watched it.  Thanks.  It is always fascinating how CI surgery protocol varies from place to place.  In the US, it is almost always out patient surgery.

 

One of the really great things about Med-El is that they are backwards compatible.  They ensure that all of their cochlear implant users can benefit from the newest sound processors and the newest fitting software advances.  Ten, fifteen, twenty years after our implant surgery we can still benefit from new advances from Med-El .

 

It is the combination of OTOPLAN 3 (for our surgeons/audiologists), Maestro 9 fitting software used by our audiologists (not yet FDA approved in the US) and the new, advanced chip in the latest processors (Sonnet 2 and Rondo 3) that makes this anatomy based fitting possible.  So CI users with older internal devices can also benefit from anatomy based fitting as needed.

It’s nice to know that Med-El supports us over our lifetime.

[tmscarlett10]

On 1/26/2021 at 8:16 AM, Mary Beth said:

@Kirk S.

Think of ASM 3 as a firmware update. When my Sonnet 1 processors using ASM 1 were updated to ASM 2, my audiologist just connected them to her computer running the Med-El fitting software to make that update.

 

I do not think any of the enhanced features of ASM 3 will change your present situation.  The features are mostly front end pre-processing features to help us hear better in noise.  

 

On 3/2/2021 at 4:09 PM, John R said:

@tmscarlett10 Consider MAPping an old fashioned "Tune Up" on an engine. decades ago when you bought a new car, you had to "Run It In" everything was new, and after a short period of time needed to be tweaked. "Don't push the engine too hard too fast, let's put a few miles on it first and then we can fine tune it". 
Personally I find the use of the word mapping ( MAPping ) a bit dumb. it really is just adjusting the settings and fine tuning Your CI to Your cochlear and current brains capacity to interpret pulses through the electrode array. We are all different and our "Maps" are too. each electrode can have different impedance's, frequencies, etc etc. unless you are a tech head like myself just go with the flow, Everyone loves the sound of a V8 over a 4 cylinder car engine. YET with motorbikes its the opposite, a V Twin ( 2 cylinder ) sounds way better than a 4 cylinder @Kirk S. I know agrees with me there. bottom line is they will all get you from A to B. not everyone wants to know what oils are used, or what spark plug gap you have.   Ask me in private what ever Tech stuff you want to know and ill try my best to answer it. cool thing is the Synchrony 2 is a V 12  

 

On 3/2/2021 at 4:52 PM, Justin said:

I'd like to echo what @Mary Beth said re: mapping. On Sunday night I started writing a response to @Jared Charney regarding sharing research learnings to an audiologist... but I got so tired I just started rambling and didn't post it! Crack of dawn wake up got to me!

The top 3 things you can do to have success in your early mapping sessions is as follow:

1. Choose a competent audiologist experienced with CIs. They don't need to be a world leading expert... at this point.
2. Establish good two-way communication with the audiologist.
   a. Figure out how to describe what you are hearing/experiencing in words that your audiologist understands (this is actually hard!).
   b. Speak concisely during mapping sessions - time is limited and you want every second to be put to good use!
   c. It helps immensely to have notes or write a letter/email to your audiologist – and have them read it before or at the beginning of your session.
3. Trust you audiologist and be patient! You'll want results fast and more, more, more! You'll think you know better than them, and could do a better job it they just did what you were asking for, or if you could do it yourself. Or if they applied the latest research you read about online. NOPE! YOU'RE WRONG! If you over-shoot on levels, you will feel like your head is going to explode. And you'll be back at the audiologist begging for mercy. Ask me how I know this!

In the early mappings, it's all about slowly bringing up levels and giving time to adjust. Don't change too many things all at once! Do lots of rehab and take note of how you are improving - it's easy to lose sight of the gains you've made and fixate on what you don't have yet. Also, most deliberate rehab is streaming... but remember that streaming is not the real world. This is especially true if you have better hearing in another ear - you should try to appreciate if you can hear/understand better in noise or social situations vs. fixating on how streaming doesn't sound as good as you'd like it. 

I'd say around the 1 year mark, it's worth assessing whether you're happy with your audiologist. Hopefully, you're a textbook case and all the best practices are just right for you. But maybe you're special and the audiologist needs to get into those special options or needs to take extra time to dial in the just right combination of settings. I don't think you have all the data to make this determination before about 10 months or a year, unless something is clearly very off. Trust the process. 

Another tip: it's worked well for me to keep one programming slot reserved for my favorite "old" program. This is especially true if we were boldly trying new things on the other programming slots. Often I'd hate a new program and spend the first few days toggling back and forth until I realized the new stuff is actually better.

 

On 3/2/2021 at 5:22 PM, Justin said:

Another thought on mapping: A super important part of mapping is setting upper and lower threshold. The audiologist will stimulate one electrode at a time, gradually increasing the amount of stimulation, and ask if... a) you can hear it (lower threshold) and b) if it's "too loud" or "uncomfortable".

For the longest time, I gave the wrong answers!

I was saying "I can hear it" at the slightest hint I could hear it, and sometimes I may have been guessing or going off of some non-auditory sensation. Only say yes if a lower theshold is clear you HEAR it (but the step below you don't *clearly* hear it). And for upper levels, watch out for distortion and plateauing. I never get to uncomfortable. On some electrodes it just stops getting louder, or it starts to distort. On other electrodes, I start to have non-auditory stimuation (neck or forehead muscle twitches, or my opposite ear drum flutters). Non-auditory stimulation kind of tickles me, so sometimes I let it slide which is a mistake. Stay below any level where these things are happening! Find the step where the stimulation is clearly louder than the previous step, and where it doesn't distort or cause any discomfort.

Setting the levels above maximum or below minimum will cause you to effectively lose resolution of what sounds you can distinguish. Don't ask for "higher" levels or think you're awesome for hearing really low levels that you're not actually hearing. It's really important to set aside your ego and expectations and get this right!

And FWIW, for me, triphasic stimulation (and the right settings thereof) seems to really help. Better levels without the extra sensations, further allowing us to dial in good levels.

So sorry for this late late reply...

So, next week is my second activation. I don't think I should expect much. But I am still curious as to how all of this works.

Like you said @John R, "not everybody wants to know what oils are used". This girl does! I like learning new things and being in "the KNOW". (BTW, I don't drive, so I don't really know anything about cars; but I got the message 😉)

Thank you, @Justin, for the MAPping tips. I am gonna have to work on 2 and 3, lol (I haven't worked long enough with my audi to know whether or not I trust her, and I can be a bit of a know-it-all 😅).

Btw, it's funny you mention a "textbook case", because I am definitely NOT a textbook case! Though I will ask my audi for a device assessment/integrity test for the left ear, most likely it isn't working because the auditory nerve is damaged from a brain tumor removal in the left cerebellum. This is also probably the reason why I was getting nothing but facial stimulation at my first activation and following MAPpings (not sure if triphasic stimulation would work here either, but I will ask). So anyway, I am definitely difficult; ask all of my specialists 🙃. (I consider myself to be a bit of a guinea pig when it comes to doctors) 🐹

So, after activation, and hopefully getting some sound in the following MAPpings, I want to try to keep up with what my audi is doing, and not just sit on the sideline. So far I've got: no sugarcoating if you can/can't hear something... Anything else I should know, or could find useful? I do remember a discussion about turning certain electrodes off or on.. would somebody mind enlightening me on that subject, and how it would help to turn off an electrode?

 

Aside from all of that, @Mary Beth, referring to an old discussion from post-January chat, and regarding ASM 2 and 3... It sounds like when you upgraded from ASM 1 to ASM 2, it was done via computer. You also mentioned that Sonnet 2 and Rondod 3 come with a compatible chip for ASM 3; is this correct? Does a software upgrade cost anything (as would a processor upgrade before eligibility)?

 

THANKS Y'ALL! 

[Mary Beth]

@tmscarlett10

no cost to upgrade from ASM 1 to ASM 2.  Just happened at an appt with my audiologist.  So only the appt fee.

[John R]

4 hours ago, tmscarlett10 said:

This girl does! I like learning new things and being in "the KNOW".

@tmscarlett10 would you like to try a google meet or Skype?
in in QLD Australia so need to consider timezones, but if you can make it work happy to try, as you know Google Meets has captions. 

[tmscarlett10]

4 minutes ago, John R said:

@tmscarlett10 would you like to try a google meet or Skype?
in in QLD Australia so need to consider timezones, but if you can make it work happy to try, as you know Google Meets has captions. 

@John R, sure we can try a google meet, since it has the captions.