Sound experiences with CI and acoustic ear

[Mary Beth]

@Jared Charney and @Amy

Taking Amy’s advice and started a new topic.  It will make it easier for others to find it.

Definitely the most important thing in our forum is asking questions and sharing experiences.  
 

So ask away @Jared Charney

 

[Amy]

Quoting @Jared Charney from the other thread:

"ok, I'll just ask this: right now I feel like I'm hearing more and more in CI but almost like an echo if that makes sense? I am curious if you had/have a similar experience and if you found over time that the echo or almost pause in sound becomes louder and clearer as you went on? thanks!"

AK: Not an echo...but it is different at first.  When I get a new map I get what I call "Superman Voice" Where suddenly I feel like my own voice is huge.  I also get a lot of road noise.

[Jared Charney]

yes, I hear that road noise as well and also anything that my family does in the kitchen is super loud still, hoping my next mapping session will help--

 

[Mary Beth]

@Jared Charney

I needed to have the bass electrode settings decreased a bit because I found the Sonnet mics very sensitive to bass sounds.  I could hear a lawn mower from quite a distance!  Hearing family members didn’t believe me because they couldn’t hear it until they went for a walk.

[Amy]

And here I am a bass player, whos bass setting is messed up.  Going to get re-mapped at the end of the month to hopefully fix that!  Men's voices sound like the they are all in the Witness Protection Program in my CI... Woman are mostly normalish.

 

[Mary Beth]

@Amy

Although setting the bass electrodes was easy and straightforward with my OPUS2/Rondo 1 processors and resulted in great bass tones, it was very tricky with my Sonnets.  It took several tries to get it right.  The bass electrodes sounded fine at the appt and speech in quiet sounded fine, but in real life my Sonnet settings were too bass sensitive.  So we eased off the bass settings bit by bit on several appts until we got it right.

Looking back, maybe we should have eased off bass settings on my Sonnet and created that MAP.  Then eased off more bass settings and created a separate MAP.  Etc.  and loaded 4 versions on my Sonnet for me to test out in my real life.  It may have reduced the number of appts it took to get the bass settings on my Sonnets correct for real life sounds.

[2monkeys]

How does one know if a different map is needed? We go back for our 3-month follow up in a few weeks. 

[Amy]

6 hours ago, 2monkeys said:

How does one know if a different map is needed? We go back for our 3-month follow up in a few weeks. 

I am not sure I would have a definitive answer. All I know is, male voices were sounding a lot more clear to me prior to my last mapping.  I assume that the last map I had somehow tinkered with my hearing on the low end, and that's why they sound weird.  But honestly I am just guessing here.

[Mary Beth]

@2monkeys

Your child’s audiologist will know.  She will conduct some tests and ask some questions.

If you or your child ever notice an increased difficulty in understanding, it’s a sign that a MAP adjustment may be needed.

[Justin]

I kinda feel you could always try a new mapping, and a good audi will keep finding things to try an hone in on. There are practically infinite combinations of settings and things an audiologist could try, and changing too many parameters at one time usually doesn't work out well. Also, it does take time to fully appreciate how a map is working out for 'ya. What is annoying at first may be great after getting used to it, or vice versa. So we do regular mappings until we think we've hit perfection or get burnt out on the process. I still enjoy working with my audi and I do get continually better results.

I generally find that I settle into using just one of my programming slots. Then I go for a new mapping and I keep that favorite old one on slot 4, and  try new stuff on the other 3 slots. Usually 1 and 2 are the same new thresholds with different microphone patterns. But I don't notice that much difference in mic patterns and I often forget to switch back from "focused mode" to "natural"... so that feature is probably not helping at all (can't wait for ASM3.0 so the processor does this for me!). Slot 3 we get to have some fun with. Pretty much every single time I end up liking one of the new programs more than the old one. And the process just repeats! Iterative progress. 

I did go for over a year, maybe 1.5 year without a new mapping, but just in the last three months and a half I've had two sessions. The closeness of these appointments actually created an opportunity to have somewhat of a breakthrough (switching to triphasic was a big piece).

[Justin]

@Jared CharneyTo youroriginal post: CI+Acoustic for me is great! I have a few theories on what you're experiencing. You could still be adjusting to hearing new sounds with your CI and thinking you're hearing weird sound effects. Not sure you meant that you were hearing your own voice like someone else suggested, but I don't think it's that. One thing we don't appreciate is that many sound environments are reverberant. Acoustic ears do a good job ignoring reverb (two ears do it really well), but CI microphones and CI coding strategies (thus far) don't seem to handle it well. You may be cluing into hearing the echos from reverb that you didn't notice before.  Finally, I did have a flanging effect that was pronounced at first but is much less a problem now. If sounds could have a "halo" or motion blur, it'd be like that. I think this was residual activity/stimulation in my auditory nerve after the sound finished. It's gotten better on its own over time, but also triphasic stimulation helps reduce unintended/collateral stimulation so that might be worth a try at some point.

[Justin]

@Jared Charney Ha! Reading MED-EL's most recent "blog post" and it said this:

https://blog.medel.com/i-miss-something-when-i-only-wear-one-processor-jannettes-story/?utm_source=Forum-Hearpeers-Blog-Feed-Article&utm_medium=blog-feed-hearpeers&utm_campaign=Forum-Hearpeers-Blog

Quote

Many CI users report a Mickey Mouse-like voice, but I can’t confirm that. For me, everything echoed a bit, it clanged. But pretty quickly everything sounded natural to me again. Even if with a little echo.

Sound familiar? 

 

[Jared Charney]

@Justin thanks! when I was first activated and for the first month when I streamed to the CI every voice sounded like Gollum for LOTR. My aha moment came when I was listening to someone with a British accent and I started noticing that the more I listened to people with accents the better I could hear them and a lot of time if someone is talking say on Youtube without a lot of overlaid sound I can turn off the CC. Can you explain Triphasic stimulation? Thanks so much for your input again you and @John Rhave such unique insights I wish I could bring one or the both of you to my next mapping session!

[Justin]

Triphasic is a way to try to not "leak" current everywhere. Or put another way, to not electrically stimulate nerves that aren't supposed to be stimulated. If current goes where it's not supposed to we'll either hear unintentional sounds (wrong part of the auditory nerve stimulated or the auditory nerve bundle), or we'll have face/neck twitches and tingles.

(Note: I'm intentionally NOT using proper terminology here so it may be more approachable by non-engineer types... or not.)

The way it does this is using pulses with 3 phases instead of 2 phases. Both pulses have positive and negative phases that must balance out, or else CIs would hurt! The 3 phase pulse balances things out in such a way that it doesn't create as large of at electrical charge difference all at once, but it does create an equal amount of stimulation for the targeted nerves near the electrode.

 In a normal biphasic pulse, the electrode sends out positive current for a bit, then switches to the opposite polarity for the same amount of time. This basically shoots out electricity and then sucks it all back. The net electrical charge at the electrode goes 0 -> +1 -> 0. At the point when the phase shifts, you could say it's put out 1 full "pulse unit".

The 3 phase pulse simply puts out half a pulse unit, then sucks back a full pulse unit, then puts back out a half pulse unit. So the net charge goes 0 -> -0.5 -> 0.5 -> 0. The net maximum charge in either direction is never more than +/-0.5.  The nerves close by get the same total stimulation, but there's less excess current to wander off and mess around where it shouldn't go.

Without triphasic as an option, your audi has to reduce thresholds for problematic electrodes, possibly to a point they don't perform well. Triphasic pulses may help reduce undesired stimulation, and then your audi might be able to actually increase thresholds to where the not only feel good, but sound good too. And the stimulation should be more focused on the nerve endings closest to the electrode, so you won't get any bleeding of sounds across electrode sites which causes sound distortions.

Here's the more official description:

https://blog.medel.pro/triphasic-pulses-for-facial-nerve-stimulation/

 

 

[Mary Beth]

Great explanation @Justin

@Jared Charney you can find more info on triphasic pulses here too