by In Wales
Sun Apr 1st, 2007 at 09:02:19 AM EST
Today I make the switch from analogue to digital - hearing aid.
I've been analogue all my life, since I was first fitted with hearing aids at aged 3, and after a quarter of a century I'm turning digital.
In the audiology clinic last week, I realised how much has changed in that time, technology-wise. And yet much about the experience remains the same.
So here's a trip through life in and out of the audiology clinic.
Apparently, as a baby, I stared at everybody. My big brown eyes would silently follow people wherever they went, often freaking them out. I never slept, and screamed the nights away until I was about 3.
I also failed to respond to noises and voices and anything else that was out of my sight. Yet I said my first word at 9 months ('Bird', for trivia fans).
The doctors failed to take my parents' concerns about my hearing seriously and it was a long battle to get a diagnosis. Back then, I was sat on my Mother's lap whilst the doctor walked behind me and shook a rattle. The fact that I turned around when he did so was conclusive proof that there was absolutely nothing wrong with my hearing.
These days, you can test a baby for hearing loss within a few days of birth. Immediate diagnosis and off they trundle, baby and parents, into the big bad world of The Medical Model.
My earliest memories of audiology are mainly centred around little rooms, otoscopes being shoved in my ears, feeling audiologists breathing on me while they looked at my ear drums (this could well be where my dislike of having people stand too close/breathing near me comes from). Here's an otoscope.
I have happier memories of bouncy balls being made from the leftover material that the ear impressions were made from. Here's an area of change - the materials that are used to take an impression of the ear have progressed since I was little. It consists of a base and a mixer and the two are mixed together, shoved into a syringe and squeezed out into the ear.
I can always tell whether or not a mold will fit from how the impression feels. It needs to be packed tightly and go deep into my ear, otherwise the mold that results is too loose and the feedback is terrible. Colours for the impression material have changed from blue to pink to green and now a lovely purple. My audiologist says the latest stuff is much better, less greasy and easy to mix, decent hardening time. The material used to be bouncy when it hardened. Very, very bouncy.
The resulting mold can come in a number of materials, hard/flexible with and without vents, pink, transparent, glittery, coloured and with logos.
Info on molds. Hearing aids come in different colours now. I always had the bog standard block of beige plastic hooked onto my ear. And a pink or transparent mold. Such as this - this is a mold made for my right ear about 10 years ago. I was only used for a few weeks before an accident damaged that ear so badly that all the residual hearing was knocked out. I keep it as a reminder.
My right ear now displays piercings that freak people out. Tragus and anti-tragus piercings. I decided that my ear had to be good for something.
My absolute favourite experience was the hearing test itself where they put the too big headphones on me and I had to put a colourful wooden man in a wooden boat whenever I heard a beep, until the boat was all full of wooden people. As I got older, the wooden boat became a hand held button which I pressed whenever I heard a beep. Not half as exciting.
I remember there being a whole series of beeps, loud, quieter, quieter, quieter until I couldn't hear the next one. At least 4 or 5 beeps for each frequency.
BEEP, press, BEEP, press, beep, press, beep, press...
Now I have just the one beep and even then I am not always sure if I have heard it or felt it or if it is just my tinnitus. I can hear sounds of about 110dB - equivalent to an airplane taking off. Normal conversation is around 45dB. People with average hearing can hear sounds of 0-10dB. Bear in mind the dB (decibel) scale is logarithmic. I'll let a mathsy person work out the factor of difference for me (my hearing is 10 times 10 times 10 times 10... times worse than the average.)
I hate the bone conduction tests where my head is put in a vice (ok, not really but it feels like it) and the sound is fed in by vibration to the skull. Horrible.
I think I quite liked all the attention that came with a trip to the audiology clinic. I didn't understand how I managed to amaze them all or why they thought I was so clever, but it wasn't too much of a chore to be there. My surgeon has been seeing me since I was 6 years old. Apart from immediate family, he's been around in my life longer than anybody else I've ever known. He's got to retire one day and I'll be sad when that happens.
He's operated on me a number of times, including the surgery when I was 8, where he came up to the ward still in gowns and cried as he explained to my parents that the ossicles of my middle ear had crumbled, making my hearing worse. The following year they shaved half my head and went back in to try to repair some damage, and that didn't work either. I didn't mind, because I had't wanted the operation anyway. I didn't want to be hearing things I wasn't used to hearing. I didn't like the idea of not being able to turn the volume down when my childminder's children were screaming.
But I thought that perhaps I could pretend it had worked, then we'd all be winners. He scratched my head and asked if I could hear it. I said yes. He knew I was lying. My Mother wouldn't believe it hadn't worked and kept telling people we were just waiting for it all to heal and then I'd be able to hear better. I knew it was worse again.
It's much more of a chore now, to go off to the specialist hearing rehab clinic (a separate one from my ENT surgeon). I sit through the hearing tests that flare my tinnitus right up. We chat about how I'm doing. 'When could you last have a conversation on the phone?' ... I don't remember. 'How do you find it with background noise?' Impossible. But I'm used to it.
I was refered to hearing rehab after my accident to see if I could be suitable for a cochlear implant. I still manage on the level of hearing I do have, so it isn't worth the risk. I won't talk about implants now, but this is an area that has changed immensely over the years. Yet the implications for my self identity are huge should I ever find myself seriously considering an implant. My heart never wants one, my head knows I may need one. It is going to tear me in two one day.
I did some speech discrimination tests - watched a video of a man speaking a number of sentences; without sound, with sound and sound only. I always perform amazingly well on these tests. My brain is one hell of a processor. These are all random, out of context sentences and yet somehow I can take all these little bits and put them together and work out what is being said 80% of the time. My audiologist has never come across anyone with such poor hearing who can get any, let alone most of the sentences.
I'd argue that this doesn't translate into real life. People don't speak clearly, it's never that quiet and I am never given the 3 second delay my brain needs to process what I am absorbing. Also, I may get the gist but not the detail. Missing out one or two words in a sentence completely removes all meaning. I always look down to my right when I am trying to process sound. Which bit of my brain is working there, does anyone know?
Well anyway. I have lost more hearing. I am well into the profoundly deaf category, yet somehow managing (although less well these days) on the tiny bit of residual hearing I do have. The move to digital has to happen because it is the most powerful hearing aid available. It can also be fine tuned on the computer to match my frequency range, and to tune out feedback where it occurs. It has 3 settings; program 1 which is default; program 2 designed to filter out background noise and program 3 which is for loop systems.
Here it is, with a flexible pink mold!
(NB: The in the ear aids are nowhere near powerful enough for my hearing loss and frankly, people don't believe me when I say I am deaf anyway and having a nice big thing on my ear helps with the convincing.)
It sounds slightly different from the analogue. It feels as though I am listening through something. That may seem obvious but it's hard to explain. It is almost as though the microphone is somewhere away from me, rather than it being a part of me. I tried an older digi model a few years ago and felt constantly dissociated while I was wearing it. Plus it also picked up too much background noise like footsteps and crisp packets rustling and I was too distracted by all these strange noises I never usually heard.
My plan is to calibrate my brain somehow to get used to how things sound. I'll listen to some of my favourite tracks on my MP3 player via the loop until I get used to any difference. At work, I'll chat to people whose voices I know really well until my brain can figure out what means what.
The real test will be background noise. Will it filter it out or will I be hearing things I don't usually hear? Certain frequencies may stand out more or maybe it is perfectly tuned to what I need. The buttons and switches are all different, so my fingertips need to learn what's where. So, I'll see how that goes.
It is lighter and a tiny bit smaller than the analogue - here they are for comparison.
This is the end of the line for me. Any further deterioration in my hearing or ability to manage on what I do have, leaves me with nothing or surgical options only.
What has never changed is the fact that I am always the youngest person in the clinic. The issues are different for me. I'm not some 50-something struggling to remain as a hearing person, battling with a 'loss'.
I'm just doing what I always do, living my life and finding my way around the barriers that crop up. Often going through the same routine of explaining to people why I can't understand what they are saying, but I can understand someone else, that I don't need anybody's pity, I'm not incompetent or stupid, and I don't need praying for - I'm just fine as I am.