Welcome to the forum Shane. I had my surgery in January and activation was Feb 1. I elected to go with Med El and the longer array (Flex28). A post op CT scan was done and will be used to adjust the current mapping to match the actual electrode positions for better hearing. A feature ME uses called anatomy based fitting.
The surgery used a newly introduced robotic assist (IotaMotion) for extremely slow and steady insertion. No complications although my residual hearing in my implanted ear is close to 0 right now. 2 other side effects I experienced that I was not aware of were numbness on the top of my ear and hearing my own pulse.
The numbness comes from cutting of the surface nerves to make the incision. I am told this will come back. After 6 weeks I can tell already that it is. The pulsing sound has dropped off a bit, but it and the constant popping in my ear sounds metallic. I take that as some evidence of residual hearing as this is sound that is created in my middle ear.
Glad to hear that your surgery went well and that you are recovering well.
Iām booked for CI surgery in April and am choosing the Mel-El CI for the same reasons as you - longer array (which theoretically means better āPitch Placementā of the electodes in the cochlear), anatomy-based fitting. I have no functional hearing in my left ear at any frequency, so getting the lower frequencies close to where they need to be in the cochlear is what Iām hoping for.
How are you finding the sound you are getting from the Mel-El? Do you have any challenges with streaming, seeing you need to use an additional device to stream with Med-El?
You should post your audiogram so others can see the hearing profile you have to understand your perspective. My activation was Feb 1 so I am still a ways away from āmajorā improvements. On Thursday I will have my mapping converted to ABF. The initial settings were to gauge comfort and I can tell you they are generally too soft and higher in pitch. It will be interesting to see how much this changes.
MED-EL like I assume all the CI manufacturers has a very useful and well used forum (HearPears) where people share experiences and suggestions.
As for streaming, anything BT centric can be tricky, but am having some success. Older phones and HAids can make it more challenging. Have upgraded my phone (S23) and will do the same to get an HAS compliant HA. Battery life will always be a management issue, but they provide 3 rechargeable ones and an attachment for disposable ones (72 hrs) for time when its hard to charge (overseas travel?)
Time for an update. Its been 6 weeks since my surgery and 4 weeks since activation. I went with MED-EL for their longer array (Flex-28),use of lateral wall arrays, anatomy based fitting for closer match of frequency stimulations to actual electrode placement, and availability of a wireless processor. I also used a robotic insertion assist (IotaSoft) to minimize trauma.
I have noticed several things since surgery:
My implant placement is a bit low and as a result it is crowded when I wear glasses. The Sonnet 2 coil actually almost touches the processor.
I have little detectable hearing in my implanted ear, even though I can hear my pulse and ear pops that are quite loud even without my processor on. The sound is almost metallic like a spring being tapped. I assume this means that internal vibrations are being picked up and transmitted via the electrode to my cochlea and triggering a natural hearing sensation. So I am confused about why external sound is not similarly transmitted.
As for hearing after activation I am pleased to say that this has gone reasonably well. My initial activation was with the default mapping. After about 2 weeks of very noticeable screechy sound along with a reasonable level of clearer sound, I asked about the mapping that was used. It was clear that I was perceiving sound as higher in pitch than it actually was. I could measured this on the piano as 2-3 notes higher.
When questioned by audiologist confirmed that ABF had not been used initially because they wanted me to become comfortable with the implant volume level first for the first 6 weeks. That might have been useful to know in the beginning.
Consequently (at my request) I had the mapping changed and my hearing improved noticeably. The screech is gone and the clarity has improved measurably. My daily testing with the app they use (Hearos) has steadily increased. Although I still have a long way to go, my scores of correct word recognition (without background noise) is 80-95%. My word recognition from past audiograms was generally <10%.
So my conclusion so far is that has been a decided improvement for me even at this point, and I am optimistic that it will improve even more. I plan to meet with my surgeon to address the issues I mentioned earlier. For others, I would advise to ask questions when you experience something different than what you were expecting. Donāt assume that your current experience is either the best it can be and you just have to gut it out. As in my case asking questions revealed that what I thought had been done was not, but a timely correction saved a lot of frustration and provided faster adjustments.
The metallic sound you are heating could be liquid in the middle ear, maybe. When you walk do you hear a drumming sound with each step?
This sensation went away at 6-8 weeks for me.
I donāt hear any sound when I walk per se. But if i jump or even shake my head, I do hear that metallic like sound. Hard to believe it is fluid after 6 weeks with the popping I have, but maybe.
Wow thatās excellent news!! How is everything going now?
I never responded because you all are way too technical! All Iāve got is, yep! I can hear! I got medel 28 electrode array or something like that.
My CI is the best thing that ever happened to me. Itās like Iām back in the game! It took me a lot longer than six weeks though so I bet that is a relief! My first month was the most miserable experience ever. It wasnāt until 6 months to one year to really settle in.
As for tech extras,
I donāt like Audiosteam bc itās too big and hangs awkward behind my ear. Although, I still wear it all of the time with an activity hook and the hook helps a little.
Iāve had it replaced maybe six times bc it keeps failing. My warranty is up soon so Iām not excited to have to pay $300 for a new one when it goes.
But Iām hearing and feeling better than ever.
I donāt like Rondo bc itās like a hockey puck in my head, but I hear great with it and I like that itās more resilient to moisture. Iām grateful I have both.
The streaming through Audiolink and Rondo is okay but you have to keep Audiolink close to the CI. It does work well for a mic though.
I had a word understanding on 98% on my last test and I think it was 88% in noise. Fabulous results!
Forgive my elementary understanding of yāall.
I am now almost 4 months since activation and it is clear I continue to make improvements in speech understanding even in a crowded environment. Much of the rehab has been word identification and I still struggle with M/N and TH/F, but in fairness I would probably be able to understand the word if used in context with a discussion. A conversation about baseball would not confuse gain for game.
I have found that I have settled into a routine on use of the equipment. Rondo 3 (wireless) for around the house, watching TV, rehab exercises and Sonnet 2 for anything outside. A hat fits over the coil easily and helps secure it. Not so with Rondo.
Speech still sounds a bit distorted and while improved and understandable with new settings for noise or wind reductions, it is still a ways to go to match what I hear in my other ear. Music is still a big challenge with the implanted ear and phone calls on my cell as well. I am getting a new HA that will pair with the CI and see if this makes streaming of calls better. More to come on this.
Itās great to see you posting again. You have been missed.
As for posting in āJargonā, itās something that drives me crazy. People learn a new technical term and then wear it out using it an others in their posts. I donāt know if they are trying to impress someone, or they actually think we all expect them to talk in those terms. If someone does that to you, ask them to clarify what they mean by that and donāt be embarrassed by asking.
Completely agree. I have Cohlear CI24RE Contour Advance (precurved perimodiolar) and to my surprise I can hear the lows too, even slighly better than 250-500 Hz range.
Theoretically, I shouldnāt hear anything below 180 Hz, but itās not the case.
I tested it by streaming an online tone generator. You may set the volume very low (important!), set the square wave, and gradually increase the loudness.
A square wave produces a stronger sound than a sine wave, likely because the stimulation impulse produced by a CI is also a square wave, making it easier to reproduce. Correct me if I am wrong.
You can test it also by Piano app e.g. Mini Piano Lite on Android.
A square wave is not a pure thing like a pure sine wave. The impulses that drive the squareness of the squarewave (to the extent your equipment can produce one - this isnāt simple) are composed of many frequencies across the spectrum to add up to that impulse shape. It might be that the thing that allows you to hear that is a higher frequency which you normally hear is a component of the squarewave to which you attribute your hearing. Just a thought.
My apologies for not providing a more accessible article on the matter than the one I found quickly.
No need to apologies, thanks for the link. I graduated from elementary music school and I know about the harmonic components of a particular tone, which we called āaliquotsā, which are odd and even multiples of the base tone frequency vs. only odd multiples in square wave.
Here are spectrum of the violin with relatively high-amplitude, high-frequency harmonics
Wikipedia even has an animation showing the transformation from sine to square wave.
It is possible that higher frequency component may add more loudness component (normally that component is provided by lows). However, when I listen to, for example, a ~82 Hz tone (E1) - I hear it just as low as when I listen to it with my better ear with HA.
This is because hearing takes place in the brain, not in the ear/cochlea.
The cochlea only translates the analog signals into digital signals for the nerve pathways. The brain retrieves the memory associated with these signals. Once you have trained your new hearing (it takes months or even years) you will hear beautifully rich deep tones for precisely this reason. Even though the soundprocessor is not capable of this. A brain is a fantastic organ.
