CI surgery in London, Canada scheduled Mar 23/21

[Coaster]

Hi, my profile name is coaster; and as per title I am scheduled for a Mel-El implant on my left ear, on Mar 23/21; with activation to take place late April.  

 

I have worn hearing aids since late 80s ( now BTEs) and while my left has residual hearing, I am struggling with conversation when using that ear alone for so have been accepted as a candidate. 

Obviously I have concerns about post surgery recovery management ( meeting pre-op soon); and more so with bilateral support between my sonnet 2 ( decided that over Rondo , as I believe I have more flexibility with batteries, activities like golf, similarity to my current BTEs) and my Phonak Q70 for bluetooth connection on my mobile device which I use a lot now for call communications and music, etc. I am really concerned but it appears the Rogers21 with individual processor connectors will provide that. 

 

So ...any advice would be appreciated. I will receive the Audiolink and AudioStream devices at activation; but my understanding their usage is limited to my CI; which leaves me with single for mobile usage until I get something like Rogers 21. 

 

Plus it would be nice to have something like my Phonak ICOM as a single tool for both ears. Sounds like I need a fanny pack to store stuff now I will have a CI. Ideas?

Edited April 1, 2021 by Coaster
Updated that surgery had intubation failure, and that I have decided to get the vaccine and enjoy summer; and will be contacting surgeon team in Aug for a mid fall surgery. .

[Mary Beth]

Wishing you the best @Coaster!  Which CI center are you using?  I go to New York Eye & Ear in NYC.

As long as your HA has an active telecoil, you can stream to both your HA and Sonnet 2 with the Artone BT neckloop.  I have been using it for over 4 years.  True hands free phone calls and tiny, light neckloop.

 

check this out

 

http://www.handsonhearing.com/user-review-on-artone-3-max-bluetooth-neckloop/

[Coaster]

Thank you Beth. I have looked at your review. I may have to manually set the pgm on the Q70 to tcoil, but I think it auto goes into the pgm when a tcoil is received. Ineed to check that out. That would be cheaper than a Rogers 21 and less components....be similar to my ICom ( neckloop) but without the pgm advancements. No problem with the neckloop....been wearing the ICOM  for 10+ years and never have to find it.  Excellent news.

Sorry, I thought I noted where the implant is to occur. 

- I am in Ontario, Canada ....surgery at London University Science Centre Hospital, in London Ontario. They and Sunnybrook Hospital  in Toronto have excellent long term implant teams. 

[Coaster]

Finally, using "awake" intubation; I was successfully implanted on Oct 18th/2022; at London Health Services Centre ,  London, Ontario Canada by surgeon Dr Parnes. 

Staples removed Oct 25

Activation scheduled Nov 18. 

Will try Rondo 3, but they have a Sonnet 2 ( my original recommended device in Mar/21) if I am not pleased. In Canada, at least Ontario, only one initial device is covered. 

Journey begins..... 

[Mary Beth]

@Coaster

congratulations!!!

Does “awake intubation “ mean you were aware of things happening during your surgery or do the meds make you unaware during surgery?

The fun begins at activation!!

Rondo 3 will allow you to use the Artone neckloop for Bimodal streaming to your CI and HA but …

-you need to attach the telecoil adapter 

-put your Rondo 3 into flight mode to avoid a ticking sound

-it defaults as a MT 50/50 mix that can not be changed by the user however our audiologists can make a program for 100/0 (T only) in another program slot.  (If we wanted to use that program we would need to move into it before putting the Rondo 3 into flight mode.)

Sonnet2 has an internal telecoil so none of this is needed with Sonnet2.  We just use the app or remote to move between M, MT and T in any of our program slots.

Let us know how your activation goes!  Wishing you the best.

[Coaster]

An "awake" intubation is keeping alert and able to communicate until they have inserted the breathing tube while partially sitting up in the bed , in my case using fibre optics to allow the anesthetist to complete the other procedure, and then knocking you out before sealing off the windpipe. I had an experienced anesthetist and found my throat significantly less raw than the first attempt in Mar/21. A dental type spray, to numb the throat gag reflex,  is used prior to insertion. 

Fyi: note detail or video can found using online search

Is that the major technical difference, the tcoil support, btw the sonnet 2 and Rondo 3?

I am SHNL since 1987, with bilateral BTE  HAs prior, so being bimodal with the HA for synchronization input is important going forward. Currently Phonak Q70 plan to get left one revised to match the right as a spare. 

Yes, the fun soon starts. My expectations of quick brain plasticity is high, but I recognize the realities that time and sound therapy may be longer. It is what it will be.

 

Have ignored the HearPeers site for past 1.5 year, but expect to be on here a lot more to learn, perhaps help others. Need to add a pic and include my first name in the profile.

Good to see you are still here Beth. Your expertise provides help to many.  🤗

[Mary Beth]

Thanks for your kind words @Coaster

The awake intubation must’ve been interesting.

To me there are several similarities and differences between Rondo 3 and Sonnet 2.

Similarities-

1) They offer the same sound processing options for our audiologists.

2) They both have advanced, faster computer chips.

3) They both work with the FineTuner remote or the AudioKey2 app as a remote.

4) They both work with AudioLink- the intermediary device.

Differences-

1) off the ear versus BTE

2) Sonnet2 has replaceable batteries and works with micro, standard or the new MAX rechargeable battery as well as disposable batteries. (I use disposable Power One implant batteries and get two very long listening days with streaming.  I replace the batteries every other morning and never experience an inconvenient dead battery.). Rondo3 only uses rechargeable batteries and some adults run out out of battery power before their listening day is done.

3) Sonnet2 has the AudioStream BTLE direct streaming from phones/tablets.  If you have an android phone that uses dual audio and a compatible hearing aid (Phonak is not compatible) you can stream simultaneously to the Sonnet2 and HA.  Rondo3 does not have a direct streaming option.

4) Sonnet2 has telecoil built in so M, MT and T are options on all programs.  Rondo 3 uses the telecoil adapter as described above.

5) Rondo3 waterwear cover is form fitting so it it very comfortable and does not produce any rubbing sound on the mics.  Sonnet2 waterwear cover is not form fitting and some users do report rubbing sounds on the mic

Other HP members may have more to add.

Although Sonnet2 would be a better match for me (especially because of the battery life of Rondo3 and the telecoil), at our monthly GoogleMeet chat last week a show of hands was pretty much equally split on preferring Rondo 3 or Sonnet 2.  The off the ear design of Rondo 3 is very popular.

I am glad you can try both and decide.  In the US, some CI centers give two processors with surgeries and others give one processor with surgeries.  Upgrade kits are always just one processor per implanted ear.  Most people at one processor centers in the US have to choose Rondo 3 or Sonnet 2 without being able to try them both first or change later.

[Coaster]

Thank you for the comparison points. The clarity helps. 

The tcoil and battery life may be a deal breaker to if I go with one unit.

I have a short term option to purchase a 2nd device but the cost is still not insignificant. I prefer to use some it for a new cell phone and support like a artone neck loop.  I am not sure why technically the compilot2 neckloop would not work with CI tcoil as I think they are both induction driven.  Tough to obtain information. 

I noted and printed a response you provided another HP member on settings that I find interesting and would like to obtain more knowledge do plan to research links you provided in that response.

Having had HAs for approx 35 years, I find the more I understand technically, the better fit I can obtain when communicating with the audiologist or dispenser when fine tuning settings.  But that stage has improved significantly since the days of analog or early digital HAs... A lot quicker and smoother transition for new devices setup. The algorithms are so much better today, that mainly use the main auto program except in rare scenarios. 

Thanks again... Herb ( Coaster)

PS:  the article of settings I commented on above... I seemed have lost the original response link but this is a copy of info. Looking forward to checking it out further. 

https://content.invisioncic.com/n283099/monthly_2022_02/743B1FCA-D143-4907-A930-BFAF7C5C7567.jpeg.d700aece65bf5fc6d7bad51b7064d03a.jpeg

 

 

Strategy: fs4-p

FS4-p is the speech processing strategy you are using.  Info can be found here:

https://silenceamidstsound.wordpress.com/2014/12/19/med-el-speech-processing-strategies-fsp-fs4-fs4-p/

 

FS: 100-8500 Hz

This is the frequency range you are set to hear.  100Hz to 8500Hz.  And this was the default values when we were activated.

 

Maplaw: 500

Maplaw is the output compression function.  This is the default value too.

info can be found here 

https://pubmed.ncbi.nlm.nih.gov/19301240/

 

 

Compression Ratio: 3:1

compression ratio 3:1 is default as well.

 

 

Default Volume: 90%

your MAP is set at 90% volume so you can both increase and decrease volume by the remote

 

Default Sensitivity: 75%

This is the default setting for the sound bubble the processor gathers audio from.  You can both increase and decrease sensitivity by the remote.

 

AI: Mild ;Directionality: Natural

AI Mild stands for adaptive intelligence mild which is an ASM 3 option.  It uses the natural mic setting.

[Mary Beth]

The compilot 2 is a proprietary intermediary device and only works with certain Phonak hearing aids.  Like the AudioLink is a proprietary intermediary device and only works with Med-El’s Sonnet/Sonnet2 and Rondo3 (it does not work with any hearing aids).

Do a search here for AuraCast.  If it actually comes to be, it will offer universal connectivity and these other types of proprietary intermediary devices will no longer be needed.  Personally, I can not wait!

@Coaster (Herb)

[Coaster]

I will research that; yes, I do think it will eventually happen; and it will be more freedom to us with bimodal setup. 

I also understand recent cell phones allow Bluetooth simultaneously to multiple devices, which I need to confirm. My cell needs replacing, so time to to  investigate that possibility of using both induction neckloops for calls and music. 

For example Re:

https://www.gadgets360.com/how-to/features/how-to-connect-bluetooth-speakers-headphones-android-iphone-2488128

[Mary Beth]

@Coaster

We have members who are streaming direct to both a Sonnet/Sonnet2 with the AudioStream cover as well as to their compatible hearing aid from selected android phones.  It requires both an android phone that does dual audio AND a compatible heating aid.  Phonak hearing aids are not compatible.

@Bill C and @Dianna have both shared their experiences with this kind of direct Bimodal streaming and we have topics about it under AudioStream as well.

https://www.medel.com/en-us/hearing-solutions/accessories/connectivity/audiostream
 

[Dianna]

Hio coaster, the phone and hearing device must have the same bluetooth technology. Asha technoligy is blue tooth low energy...BTLE.

Oticon ha's use this, so i can stream to my phone.

I was told phonak does not use the same tech at this time.

I believe widex and another use this bluetooth technology.

I get the feeling the bluetooth technology is the subject of "discussion" developers go for the tech that "works" best with their product, not neccesarily considering other products that may or may not work with changes and upgrades.

I went with all advise using this asha technology hoping it all doesnt change in the near future!

My devices work pretty good for me, im a dinosaur and not real tech smart lol

[Coaster]

Early days. The above all helps. Thank you for the additional info... I have a bit of reading to do. 

I understand that my pronak Q,70s do not have Bluetooth. I just would think that if you have a cell with dual bluetooth, you could stream to both the compilot2 plus the streamer for your CI device simultaneously.  Interesting. 

[Mary Beth]

@Coaster

What I’ve been learning is that although we just refer to things as BT, there are various BT protocols and they differ from each other.  The ComPilot uses:

ComPilot/ComPilot II supports the following profiles

• Headset Profile (HSP)
• Handsfree Profile (HFP)
• Advanced Audio Distribution Profile (A2DP)
• Audio Video Remote Control Profile
• (AVRCP)
• Phone Book Access Profile (PBAP)

 

The AudioStream for Sonnet/Sonnet2 is ASHA for android phones.

AudioStream can be used as a Made for iPhone (MFi) Hearing Device and supports the Audio Streaming for Hearing Aids (ASHA) technology. 

At this time I do not believe it is possible for a phone to connect to and simultaneously transmit audio to two different types of BT protocols.  But tech is changing all the time.  

[Coaster]

Ummm, that would definitely be a show stopper. 

I am not sure we are different pages in this discussion , and agree with your inputs; just that I would like to understand cell phone BT "dual audio"  connections in more detail. 

This article implies you can stream audio to multiple devices simultaneously if your cell allows dual BT and I believe BT v5 

 

https://www.androidauthority.com/samsung-dual-audio-how-to-1137101/

 

I would think synchronization between 1) the compilot2 to my HA and 2) the audiostream; may be an issue. While the audiologist can sync the CI and HA themselves; the compilot2 may create an additional delay. 

 

Ok.... As I commented previously, a lot more learning and potentially experimenting; and working with my audiologist. 

 

Btw; I think the phone list above is dated. While I think the Google 6 will not provide support, I do " believe" google 7 models have the support. 

Ok.. many thanks. 

 

 

 

 

 

 

 

 

[Mary Beth]

@Coaster

I look forward to what you figure out.  The biggest obstacle in streaming in two different ways simultaneously is audio timing.  When we can stream to two sides in some kind of synchronized way, the audio should be in sync.  We have the option to stream to two sides in mono through the Artone or other traditional neckloops and that audio is in sync.

When you get your processor and start experimenting with options for streaming, I look forward to reading about it.

I love separate left and right audio for instrumentals.  It makes me feel like I have been dropped into the center of the band.  I have that option with BOSE QC35 around the ear BT headphones, CozyPhones flat headband speakers, CozyBand BT flat headband speakers, AudioStream and DAI cables with the FM battery cover.

And I use those items- especially the BOSE QC35 headphones at times.

But in my daily life it is the Artone that is used the most by far for streaming speech like audiobooks, podcasts, YouTube, phone calls, etc because of its comfort, ease of use, truly hands free features and the ability to totally mute the processor mics and enjoy streamed audio only.

Which type of connectivity tech is a best match varies by person and the person’s individual preferences.

I love tech and enjoy learning from others.

 

[Coaster]

Yes, I will provide updates. That way we can confirm, learn, update, change; our reality and understanding. 

 

As to first comment, it does cone down to audio timing. 

I suspect it will end up being the sonnet2 and the Artone. My current compilot devices have been used so much over the years.  I suppose another option would be replacing my right HA.... Decisions decisions. 

 

Thank to Dianna for input, and you Mary Beth. You have given me lots to digest/ analyse short term and when I get activated. 

🤔🤞🙏🙂

 

[Coaster]

Update Nov 20/22.

Oh man, I am having trouble with overload with so much new info.  Lol, it is a good thing; working hard to both educate and keep my understanding organized. 

Completed a CT scan and met with audiologist on Nov 18th. Have not had an update on scan but hopefully all is positioned correctly. 

 

Audiologist was able to connect all 12 electrodes , so that is great.  Unfortunate, the coil could not be "securely"  connected to the internal receiver, even with magnet 5.  

Assume still swelling, so going to try in a couple weeks. Disappointing but patience us important. I have decided on the Sonnet 2 as  I am used to a BTE, it has the built-in tcoil, and I can use my ear mold to help secure it, even without having an EAS, which will be good for sports and activities I believe. 

- my thanks Beth in the above comparison you provided earlier. 

Audiologist ponuted out it will beva while, most likely before bimodal streaming will be useful to me, and suggested a Rogers 21 as she has a client using it. I like the idea of BTLE dual audio... So will followup with my HA dispenser on a future ( 3/6months?) BT HA when I see him soon as I am having my old left HAs assigned my right settings as HA backups. 

Question: what is a phonak streamer for CI? I need to research it, but throwing it out there. Thanks

[Coaster]

Update Nov 20/22.

Oh man, I am having trouble with overload with so much new info.  Lol, it is a good thing; working hard to both educate and keep my understanding organized. 

Completed a CT scan and met with audiologist on Nov 18th. Have not had an update on scan but hopefully all is positioned correctly. 

 

Audiologist was able to connect all 12 electrodes , so that is great.  Unfortunate, the coil could not be "securely"  connected to the internal receiver, even with magnet 5.  

Assume still swelling, so going to try in a couple weeks. Disappointing but patience us important. I have decided on the Sonnet 2 as  I am used to a BTE, it has the built-in tcoil, and I can use my ear mold to help secure it, even without having an EAS, which will be good for sports and activities I believe. 

- my thanks Beth in the above comparison you provided earlier. 

Audiologist ponuted out it will beva while, most likely before bimodal streaming will be useful to me, and suggested a Rogers 21 as she has a client using it. I like the idea of BTLE dual audio... So will followup with my HA dispenser on a future ( 3/6months?) BT HA when I see him soon as I am having my old left HAs assigned my right settings as HA backups. 

Question: what is a phonak streamer for CI? I need to research it, but throwing it out there. Thanks... Revised, ok, I see the Phonak steamer is the Rogers 21 battery casing for the Sonnet 2... Duh. 

[Mary Beth]

@Coaster

Phonak’s Roger system requires both a transmitter and a receiver to work.

Sonnet/Sonnet2 can use the Roger21 as the receiver.

It needs a transmitter to send audio to the receiver.  There are many different Roger transmitter options.  

[Coaster]

Thank you for that clarification Beth re: Rogers FM

Well, an update 🙂

Brief cochlear implant(CI)  update:

Was activated on Nov 30th, I can mostly understand my wife but takes a lot of focus at times. It seems the positioning of the external coil magnet to the internal receiver magnet is key to clarity. Not like it is great , but at least we can converse. If my mind is tired, I use the phone transcribe tool. 👍  

TV, phone, and radio is pretty useless right now. 

The audiologist has set the four available programs 1-4 with increasing volume and perhaps freq range from the audio mapping. I am using pgm1 1 and will start using pgm2 on Sat night or Sunday. I expect I will be on Pgm4 by my nx appt in two weeks. At that time I assume she will increase the volumes etc for future usage, and use the pgms for  various scenarios like maybe a group noisy setting... People with HAs( hearing aids) exposure will understand).

My right HA has been removed to force the brain to use the CI input. As Captain Tom said, " it is pretty lonely out there" when everything is turned off.

The journey has started... Lots of work and discoveries ahead.

 

 

btw, I firstopd fro