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The Dawn of a New Digital Aid

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.

If people met you, they'd know you don't need pity or prayer. And reading this is like meeting you. Thanks for setting it all out like this.
by afew (afew(a in a circle)eurotrib_dot_com) on Sun Apr 1st, 2007 at 10:06:08 AM EST
Thanks. That's good to know.
by In Wales (inwales aaat eurotrib.com) on Sun Apr 1st, 2007 at 10:10:58 AM EST
[ Parent ]
As afew says, "knowing" you from reading your remarkable diaries and your comments, I couldn't feel any pity for you, only esteem and, having read this one, admiration.


"Dieu se rit des hommes qui se plaignent des conséquences alors qu'ils en chérissent les causes" Jacques-Bénigne Bossuet

by Melanchthon on Sun Apr 1st, 2007 at 01:52:30 PM EST
I appreciate you saying that, thanks.
by In Wales (inwales aaat eurotrib.com) on Sun Apr 1st, 2007 at 02:11:44 PM EST
[ Parent ]
Cracking Diary (as usual) although it does mean that next time I'm in the big city I will be looking for that ear to say hello.

Any idiot can face a crisis - it's day to day living that wears you out.
by ceebs (ceebs (at) eurotrib (dot) com) on Sun Apr 1st, 2007 at 02:50:13 PM EST
Ah, please do. I keep forgetting I have a fellow ET-er not all that far away!
by In Wales (inwales aaat eurotrib.com) on Sun Apr 1st, 2007 at 03:00:16 PM EST
[ Parent ]
Please make the update as detailed and wonderfully cogent as this diary.

I don't know what I can do with all this data, but it certainly feels important to know.

Never underestimate their intelligence, always underestimate their knowledge.

Frank Delaney ~ Ireland

by siegestate (siegestate or beyondwarispeace.com) on Sun Apr 1st, 2007 at 05:27:32 PM EST
I admit I was looking for the "April Fools" statement at the end, given your past avoidance of digital aids. :D

My usual disclaimer: I'm not a certified audiologist, everything I write is personal not professional opinion and recollection, blah, blah.

Great diary (more nostalgia!)! Congratulations on finding a digital aid that may work for you. Please continue to tell us what it's like and how it's different from the analogue aids you've used. Digital technology was still fairly new when I was in school, so this is a perspective I never got to study.

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.

Were you being tested for lip-reading ability plus hearing (total audiovisual comprehension as opposed to what just your ears could pick up)? Every test we ever did called for turning the person around so they couldn't see our lips, so we could get as true a measure of their audio-only comprehension as possible. Is this a newer test (I haven't been in audiology for ten years now, so anything after 1997 is new to me)?

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?

If your left ear is the one with more residual hearing, maybe you're just turning to get the best acoustics? Did you do this before that accident?

By the way, I share your frustration with some of the testing conditions. My hearing is considered "normal," but in background noise I have a tough time comprehending speech even when everyone around me isn't having a problem. My classmates would test me and say there was no problem, but I could never convince them that a test in which "background noise" was a higher-pitched, steady white noise could never imitate true conditions (traffic, party chatter, etc.).

by lychee on Sun Apr 1st, 2007 at 06:09:06 PM EST
I remember speech discrimination tests in school where they said individual words and put paper up to cover their faces or made me turn away.  They always seemed to cheat to help me out.  I never understood what that achieved.  When people need to repeat a word or sentence 5 or 6 times before I get it, it's hardly fair to score it as a pass.

This time round they played a video. It showed a totally expressionless man talking almost in monotone.
First the video plays without sound, then the second section shows the man talking and has sound too and thirdly the screen is blank and it is just the sound. Different sets of sentences for each.

Sentences like;
'where is my jacket?'
'she was very. athletic. and joined. the school swimming and running. teams'
when did your aunt. get married?'

I can understand why test conditions need to be standardised but they do use unreal conditions. It wouldn't be too hard to to produce realistic background noise and see how people do then.  I'm just unable to filter out what I need from a whole mess of sound.

I do tend to turn my head for my left ear to pick up as much as possible, even when I am using a loop system where it makes no difference.  I think I always look down the the right when I am concentrating on processing sound. So I may look at someone to lipread and listen but then I'll glance down to process it.  

People who know me understand my delay and why I do things like acknowledge that I'm listening and then halfway through the next sentence and realise I didn't get the first one and ask to go back; or not get a sentence and ask them to repeat, by which time my brain has processed and I've got it.

So far this digital aid seems better than the one I tried a few years ago but I haven't worn it out and about yet.

My biggest bugbear is that the volume is difficult to control. It goes up in notches and has 4 levels before returning to the lowest one again if you press it enough times (and I can't tell the difference too easily). On analogue you can turn the dial from 0 to 4 of no sound to full volume.

Also I need to wait for my new mold to come through, because I'm getting some feedback at the moment, hence the awkwardness of not being able to easily adjust the volume to reduce feedback.

Off to work today so further testing of the technology will be taking place!!

by In Wales (inwales aaat eurotrib.com) on Mon Apr 2nd, 2007 at 02:39:59 AM EST
[ Parent ]
Thanks In Wales for sharing. Maybe you could update how the digital ones work out for you. My biggest problem is the backnoise too, wonder if the digital ones really can filter it out. But even with the hearing aids, if people mumble and lots of people do just that, it really can be a challenge.

I started to first thing tell the people on phone that if I seem to be slow in understanding what they are saying, it is because I have a impaired hearing and am not stupid.

Were I am most challenged it with being witty. I used to be good giving fast and even funny responses, making people laugh - but now I just need to long to realise what they actually said, so most of the times it is not as funny anymore.

by Fran (fran at eurotrib dot com) on Mon Apr 2nd, 2007 at 03:21:58 PM EST
Thanks Fran. It is different and taking some getting used to. Good points and bad points. I'm testing the difference in a range of situations, work, home, gym, MP3, loops etc.  I'll update once I've had chance to get used to it and calibrate my brain to the new stuff!
by In Wales (inwales aaat eurotrib.com) on Mon Apr 2nd, 2007 at 05:47:48 PM EST
[ Parent ]
thanks In Wales.  Frankly I don't like the term thank you for sharing, because I think we say it so much that it sounds trivial.  But,,,,I have to say a sincere, thank you for sharing.  

You have given me some insights that I could not have had, and I'm very grateful for that.  I hope these new technologies can be helpful to you.  But it was just so interesting to read your comments as you react to the change in the technology on you, the individual.  

for me it was particularly interesting, as I have spent many years of my lfie trying to find products to help people.  And with some new medical technologies there is just a very clear positive impact.  Like with treating coronary heart disease-- where the patient says "thank you for treating me with this angioplasty and drug eluting stent, rather than cracking my chest open".  

but for me, your diary really hit home on situations that are more chronic than acute.  Situations where one just lives ones life--the cards are dealt, and thank you it's my life and I'm proud to live it.  

reading your diary gave me an insight, admittedly a small one, into dealing with life as it came to you, and living it in a wonderful way, and adapting to new opportunities as they present themselves.  

I hope, (sorry but in my faith pray, but with no sense of pity), that these new technologies will be wonderful for you.

by wchurchill on Tue Apr 3rd, 2007 at 03:34:13 AM EST
I'm glad I've been able to help give an insight, and thanks for the good wishes!  I'll keep people up to date.

The balance for me is my self identity as a deaf person (and not believing there is anything wrong or needing fixing with me), and the need for technology to manage and get through a dominant 'hearing world'.

I won't refuse technology and cut off my nose to spite my face (as a number of Deaf people do) but at the same time I resent the pressure of a society that expects me to change to fit in and be less of a problem for it.

Like you say, a much different situation than for those with acute medical needs. Thanks for commenting :)

by In Wales (inwales aaat eurotrib.com) on Tue Apr 3rd, 2007 at 04:01:42 AM EST
[ Parent ]
All the best to you.  and I understood this completely:
The balance for me is my self identity as a deaf person (and not believing there is anything wrong or needing fixing with me), and the need for technology to manage and get through a dominant 'hearing world'.
I hope it came through in my comments, and my apologies if it did not.
by wchurchill on Tue Apr 3rd, 2007 at 04:20:06 AM EST
[ Parent ]
Yes it did come through in your comment and made me realise that I perhaps hadn't made it explicit in the diary itself, so it was a good opportunity to put it in!
by In Wales (inwales aaat eurotrib.com) on Tue Apr 3rd, 2007 at 04:57:03 AM EST
[ Parent ]

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