Remember how I said last week that Beth considers "success" to be a score of 80% or higher on AZ Bios at 50 decibels? Well, we have achieved SUCCESS! At only 3 weeks post-activation!!! Today Brandt scored 83%. EIGHTY-THREE. I am completely blown away. Even more impressive, I think, was his CNC scores--64% on total words (versus 38% last week and 8% pre-CI [at 10dB louder]) and 81% on phonemes (versus 65% last week and 31% pre-CI [at 10dB louder]).
This is just mind-boggling. Ariel was beyond thrilled and said she didn't need to meet with us anymore because he's doing so great. I was rather conflicted about that, I thought we were going to be coming in for months and months for therapy and instead we're told that we don't need her anymore!
A few anecdotes from Brandt on his success:
Our girl-cat jumped up in his lap and started purring loudly. I asked if he could hear it and he nodded. "So how long has it been since you heard a cat purr? 20 years at least?" I asked. "I'm actually not sure if I've ever heard a cat purr before..." he responded.
On the difference between his implanted and aided ear: "My left [aided] ear is so uncomfortable. The canal is hot and itchy, the sound is soft and muffled. Compare it to my right [implanted] ear, which is loud and clear, and doesn't hurt at all. The CI side is so much better."
He has been able to listen to NPR in the car for the first time in a year. He's always hated music but used to listen to NPR, particularly "Car Talk" and "The Diane Rehm Show," but had to give up on it because he was struggling too much.
On watching TV being bimodal: "I like being able to watch Star Trek in stereo! Now I have one ear for dialogue, and one for sound effects!"
Friday, October 31, 2014
Thursday, October 23, 2014
2 Weeks Post-Activation
Last night's speech therapy was beyond impressive. Brandt only missed one of the Ling-6 sounds (he thought I said "oo" instead of "mm"--it's always been his most-missed sound) and I recited them three times, so he got a 94%! For the first vowel word list (kin, keen, cane, can, con, coon, kern, coin, kine), he got EVERY SINGLE ONE RIGHT! And I repeated them all several times. I decided to try a second list (high, hoe, hay, how, who, huh, ha, he, hoy, her) and he only missed one--huh and ha sounded the same at first.
On the list of 25 random sentences, he got them all right again, same as last time. This was after he read the sentences aloud before I randomly recited them. I said, "I bet tomorrow Ariel will tell you to start doing these lists without reading them first." He said, "Let's try it!" I expected he would struggle, but yet again he proved me wrong! He only missed two words out of the entire list!! Jim instead of Jeff, and Don't laugh at the little puppy instead of They'll laugh at the little puppy.
And I forgot to mention that this is all done with his eyes closed so he can't lip read. A-M-A-Z-I-N-G.
Today was the 2-week post-activation appointment. Brandt went into the sound booth for testing, this time the AZ Bio (sentences with different speakers) and CNC (one-syllable, three-phoneme words) tests that he has done in the past for evaluations. Beth warned him, "it's going to be hard today, I expect it to be hard." But for the AZ Bio sentences, he did so well that Beth told him, "You did such a great job, I'm going to make it a little harder--it's going to be softer." He still did pretty well. He didn't do as well with the CNC words, but I was really struggling to understand some of them myself. When Beth opened the door to the sound booth, she had a huge smile on her face and said, "You did great, really really awesome!"
Beth took out Brandt's scores from May, the appointment I had missed because I had no idea he was being retested (and would be approved) that day. He had previously scored 39% on the AZ Bio sentences at 60 decibels; today, he scored 76%!!! At 50 decibels, he scored 61%. Beth said that she considers "success" to be eventually scoring 80% at 50 decibels, and she "has no doubt that he will get there!" On the CNC test, in May he scored only 8% on getting the entire word correct; today he scored 38%. For the individual phonemes, he scored 31% in May and 65% today. And he was tested at 10 decibels lower today than he was in May. Beth said, "You have exceeded my expectations--and your own." Then she told us that now the focus will be more on understanding than just detecting sound. Progress!
Ariel was very excited when we met for listening therapy. When we were first walking through the parking lot to the appointment, she yelled "Hey guys!" behind us. Brandt turned and looked at her and she was very surprised that he heard her. During our appointment she said, "You don't realize the significance of your hearing me from a distance in the parking lot, but I do!" Brandt said, "Maybe I shouldn't tell you this, but I had no idea it was you or what you were saying, I just heard noise." She said, "That's fine! Just the fact that you heard me and responded at all is great! I have stood in the waiting room calling your name six times, getting closer and closer to you, and you were totally oblivious. You haven't had passive listening skills in quite a while. This is a big step."
He got ALL of the Ling-6 sounds correct, nearly all the vowel words, and all of the sentences. Ariel added rhyming words to our protocol: cat, fat, mat, bat, etc. She originally included sat but took it out, realizing that he was going to confuse fat and sat. She kept having to remind him that sat wasn't an option, because he kept hearing it instead of fat. Then she switched to a list of high-frequency sounds: fee, see, she, vee, zee, the. I thought these would be nearly impossible for him to distinguish, but he did remarkably well. Ariel and I were joking that towards the end, they all sounded exactly alike. I had no idea whether she was saying vee, zee, or the. Lastly she read some short stories about animals and asked questions about them, and again he did amazingly well.
I'm still in awe of how well this is going. I guess after five years of torment in the Gray Area, we deserved some relief.
On the list of 25 random sentences, he got them all right again, same as last time. This was after he read the sentences aloud before I randomly recited them. I said, "I bet tomorrow Ariel will tell you to start doing these lists without reading them first." He said, "Let's try it!" I expected he would struggle, but yet again he proved me wrong! He only missed two words out of the entire list!! Jim instead of Jeff, and Don't laugh at the little puppy instead of They'll laugh at the little puppy.
And I forgot to mention that this is all done with his eyes closed so he can't lip read. A-M-A-Z-I-N-G.
Today was the 2-week post-activation appointment. Brandt went into the sound booth for testing, this time the AZ Bio (sentences with different speakers) and CNC (one-syllable, three-phoneme words) tests that he has done in the past for evaluations. Beth warned him, "it's going to be hard today, I expect it to be hard." But for the AZ Bio sentences, he did so well that Beth told him, "You did such a great job, I'm going to make it a little harder--it's going to be softer." He still did pretty well. He didn't do as well with the CNC words, but I was really struggling to understand some of them myself. When Beth opened the door to the sound booth, she had a huge smile on her face and said, "You did great, really really awesome!"
Beth took out Brandt's scores from May, the appointment I had missed because I had no idea he was being retested (and would be approved) that day. He had previously scored 39% on the AZ Bio sentences at 60 decibels; today, he scored 76%!!! At 50 decibels, he scored 61%. Beth said that she considers "success" to be eventually scoring 80% at 50 decibels, and she "has no doubt that he will get there!" On the CNC test, in May he scored only 8% on getting the entire word correct; today he scored 38%. For the individual phonemes, he scored 31% in May and 65% today. And he was tested at 10 decibels lower today than he was in May. Beth said, "You have exceeded my expectations--and your own." Then she told us that now the focus will be more on understanding than just detecting sound. Progress!
Ariel was very excited when we met for listening therapy. When we were first walking through the parking lot to the appointment, she yelled "Hey guys!" behind us. Brandt turned and looked at her and she was very surprised that he heard her. During our appointment she said, "You don't realize the significance of your hearing me from a distance in the parking lot, but I do!" Brandt said, "Maybe I shouldn't tell you this, but I had no idea it was you or what you were saying, I just heard noise." She said, "That's fine! Just the fact that you heard me and responded at all is great! I have stood in the waiting room calling your name six times, getting closer and closer to you, and you were totally oblivious. You haven't had passive listening skills in quite a while. This is a big step."
He got ALL of the Ling-6 sounds correct, nearly all the vowel words, and all of the sentences. Ariel added rhyming words to our protocol: cat, fat, mat, bat, etc. She originally included sat but took it out, realizing that he was going to confuse fat and sat. She kept having to remind him that sat wasn't an option, because he kept hearing it instead of fat. Then she switched to a list of high-frequency sounds: fee, see, she, vee, zee, the. I thought these would be nearly impossible for him to distinguish, but he did remarkably well. Ariel and I were joking that towards the end, they all sounded exactly alike. I had no idea whether she was saying vee, zee, or the. Lastly she read some short stories about animals and asked questions about them, and again he did amazingly well.
I'm still in awe of how well this is going. I guess after five years of torment in the Gray Area, we deserved some relief.
Sunday, October 19, 2014
The Wait is Over: CI ACTIVATION
October 8: Activation Day
As instructed, we kept our expectations very low. The goal for activation was to be able to tell that there were sounds in the room. It would sound robotic, and he might only perceive beeps. He was going to hate it. It was going to sound horrible. It would be at least six months before he started to even tolerate it. We'd been burned too many times before, and I was definitely not going to get my hopes even remotely up this time. If it worked at all, I would be satisfied today.
We were supposed to meet with Dr. Awesome at his office so he could check the incision and clear Brandt for activation, but due to scheduling he ended up coming to the CI clinic instead. He said the incision looked great and wondered how Brandt would do with the processor, so the audiologist Beth asked if he wanted to stay for the activation. He usually doesn't but said, "Sure, I want to see how he does!" He was fresh out of surgery so he grabbed some coffee while Brandt had his residual hearing checked. Before implantation his hearing loss was 80 decibels, severe loss. Now the implanted ear is at 95-100 decibels, a profound loss. This is actually good news, because it was 50/50 whether he would have any left at all. But it was "unique" according to Beth because he only has hearing left in the middle frequencies, when usually it's the low frequencies that remain. When Dr. Awesome came back and saw the results, he said, "That is very odd...just so weird." Are we even surprised anymore that Brandt's ears are "weird"?! Beth took out the CI processor (a beautiful turquoise color called Caribbean Pirate) and gave it to Brandt to put on. The magnet wasn't strong enough so she had to add more magnets to get the cap to stick to his head. Dr. Awesome said, "I knew he'd need more magnets, his skull and scalp are really thick." They explained that as he wears the magnets, they will push down the swelling and after a few weeks he should be able to use less magnets. (Thankfully the initial swelling that had pushed his ear out went down after a few weeks and the ear returned to more or less its original position.) As Beth was preparing to activate the processor, Dr. Awesome warned him, "You're not going to like it, no adult does. Give it at least three months."
Beth started by playing a number of tones to determine if they were "soft, good, or too loud." At the first sound, Brandt jumped in his seat and I burst into tears. I was sitting behind him so I couldn't see his face, but I'm sure he grimaced. After the frequencies were all set at a comfortable level, Beth said, "Ok, it's time to turn it on!" And Brandt was suddenly hearing the sounds in the room. He said it sounded "mechanical...I can tell there's sound there, it sounds like Soundwave from Transformers" (who speaks in a monotone, computerized voice). Beth typed everything she was saying so he could understand what was going on. Dr. Awesome asked if his voice was understandable and Brandt said, "Not quite." Beth asked if he could tell the difference between speech and other sounds and he said, "Oh yes, easy." She asked if he could tell her voice and Dr. Awesome's voice apart and he said, "You're very similar." Then she asked how the sound compared to his hearing aids and he said, "I don't have the vocabulary to describe it...it doesn't sound natural." As Dr. Awesome left he said, "Remember, this is just the start, not the finish."
Beth told us that today she was only focusing on comfort, that fine-tuning would take place later on. She put five programs on the processor, each one progressively louder, explaining that "things will start sounding clearer and softer the longer you have on the processor." Brandt said, "It's already getting better as I've had it on longer. It's not great, but it's better." Beth reminded him that he needs to primarily wear only the processor for the first month, so that his brain can adapt quicker. By the time the appointment was over Brandt was already understanding speech, with just the processor, WITH HIS EYES CLOSED!! This was only an hour since activation.
Over the next day and a half, he seemed to be understanding me better than he could with his hearing aids. He would randomly close his eyes, stick his finger in his other ear, and say, "Ask me a question." I asked things like "What is your favorite color?," "When did you graduate high school?," "What did you have for breakfast?," etc. and he understood me every time. I was having to repeat myself less often than I was used to. We were stunned. He said that I still sounded robotic and monotone, but he could understand me. And surprisingly, he doesn't hate it.
October 10: Activation, Part 2
We returned to the CI clinic two days later for "Part 2" of the activation. Brandt had already moved up to the fifth (loudest) program on the processor and said the volume was comfortable. Beth asked about sounds and he said that breathing and eating are "distracting," the microwave beeping has a "lower pitch than it used to," and strangely the only sound that hasn't changed at all is our cats' water fountain.
We told Beth how well he was doing, that he could understand me even with his eyes closed and seemed to be doing better than with hearing aids. She said, "So far, this is a really good sign." But she also cautioned us to stay guarded, because we still have a LONG journey ahead. She encouraged us to talk to each other a lot so he gets more practice with communication, and for Brandt to watch television with captioning and try to focus on listening to the dialogue.
October 16: 1 Week Post-Activation
I was very anxious to see how Brandt was going to perform in the sound booth. Knowing that it takes quite a while to get all the fine-tuning done, I kept my expectations low (the theme of this month). I figured he would miss about 75% of the words. I was shocked when he correctly repeated back each of the words Beth said: mousetrap, birthday, school bus, railroad. I did a little happy dance in my seat. Then she started reading off more words, but at a lower volume. Uh-oh, I thought. He won't be able to hear any of those, they're too soft. But he proved me wrong, he got every single one again. Then she dropped the volume again. Still got them all correct. I burst into tears. The volume dropped yet again and he got about half, but it was so quiet that I had to strain to understand them. I was trying not to make any noise because I didn't want to distract him, so when Beth opened the sound booth door, I had my hand over my mouth as my shoulders shook silently. Brandt turned around to look at me and thought I was suppressing laughter. He said, "I must have done really bad if you're laughing at me." I wiped my eyes and explained that NO I wasn't laughing, I was bawling because he did so unbelievably well!
Back in Beth's office, she told us that she is "very pleased" and compared his performance from today to how he did a year ago with hearing aids. Aided, he could understand the words at 35 decibels. Today, it was 25 decibels! At only one week post-activation!!
Next, Ariel came in for listening therapy. We had already done about six months of listening therapy with his hearing aids, ending in January of this year, so we knew the drill. First we worked on Ling-6 sounds: ah, oo, ee, sh, mm, ss. Then we did a vowel word list, where the first and last sound of each word is the same and only the middle vowel is different: pit, pat, pot, put, pet, pert, putt, etc. Then we added a new exercises, a list of 25 random sentences. Brandt read the sentences and then Ariel and I took turns reciting them for him to repeat back. At this point, I was no longer surprised that he did a lot better than he had with hearing aids--but I was very very happy.
We went out to dinner after the appointment to celebrate and test how well Brandt could do in a noisy restaurant. Despite the loud jazz music playing overhead, and several loud birthday parties (involving copious amounts of alcohol) around us, he did amazingly well. I was struggling to hear him sometimes but he didn't seem to have much trouble at all. Incredible!!
October 19: 11 Days Post-Activation
Tonight we did our listening therapy homework, and I know the words "amazing" and "incredible" are being severely overused lately, but I don't know what else to call it! With the Ling-6 sounds, I recited them each three times and he only missed a total of two--that's an 89%. On the vowel word lists, he got about 85%. I'm using the same notebook to record his results now that I used for our previous, hearing aid round of listening therapy, so I can compare his results. He used to get about 50% on both the Ling-6 and vowel word lists. Definitely a major improvement! Then we did a new list of 25 random sentences and he didn't miss a single word. We both sighed with relief and awe. It's like we've been holding our breath for the past five years and now, we can finally believe that maybe it's going to be okay.
As instructed, we kept our expectations very low. The goal for activation was to be able to tell that there were sounds in the room. It would sound robotic, and he might only perceive beeps. He was going to hate it. It was going to sound horrible. It would be at least six months before he started to even tolerate it. We'd been burned too many times before, and I was definitely not going to get my hopes even remotely up this time. If it worked at all, I would be satisfied today.
We were supposed to meet with Dr. Awesome at his office so he could check the incision and clear Brandt for activation, but due to scheduling he ended up coming to the CI clinic instead. He said the incision looked great and wondered how Brandt would do with the processor, so the audiologist Beth asked if he wanted to stay for the activation. He usually doesn't but said, "Sure, I want to see how he does!" He was fresh out of surgery so he grabbed some coffee while Brandt had his residual hearing checked. Before implantation his hearing loss was 80 decibels, severe loss. Now the implanted ear is at 95-100 decibels, a profound loss. This is actually good news, because it was 50/50 whether he would have any left at all. But it was "unique" according to Beth because he only has hearing left in the middle frequencies, when usually it's the low frequencies that remain. When Dr. Awesome came back and saw the results, he said, "That is very odd...just so weird." Are we even surprised anymore that Brandt's ears are "weird"?! Beth took out the CI processor (a beautiful turquoise color called Caribbean Pirate) and gave it to Brandt to put on. The magnet wasn't strong enough so she had to add more magnets to get the cap to stick to his head. Dr. Awesome said, "I knew he'd need more magnets, his skull and scalp are really thick." They explained that as he wears the magnets, they will push down the swelling and after a few weeks he should be able to use less magnets. (Thankfully the initial swelling that had pushed his ear out went down after a few weeks and the ear returned to more or less its original position.) As Beth was preparing to activate the processor, Dr. Awesome warned him, "You're not going to like it, no adult does. Give it at least three months."
Beth started by playing a number of tones to determine if they were "soft, good, or too loud." At the first sound, Brandt jumped in his seat and I burst into tears. I was sitting behind him so I couldn't see his face, but I'm sure he grimaced. After the frequencies were all set at a comfortable level, Beth said, "Ok, it's time to turn it on!" And Brandt was suddenly hearing the sounds in the room. He said it sounded "mechanical...I can tell there's sound there, it sounds like Soundwave from Transformers" (who speaks in a monotone, computerized voice). Beth typed everything she was saying so he could understand what was going on. Dr. Awesome asked if his voice was understandable and Brandt said, "Not quite." Beth asked if he could tell the difference between speech and other sounds and he said, "Oh yes, easy." She asked if he could tell her voice and Dr. Awesome's voice apart and he said, "You're very similar." Then she asked how the sound compared to his hearing aids and he said, "I don't have the vocabulary to describe it...it doesn't sound natural." As Dr. Awesome left he said, "Remember, this is just the start, not the finish."
Beth told us that today she was only focusing on comfort, that fine-tuning would take place later on. She put five programs on the processor, each one progressively louder, explaining that "things will start sounding clearer and softer the longer you have on the processor." Brandt said, "It's already getting better as I've had it on longer. It's not great, but it's better." Beth reminded him that he needs to primarily wear only the processor for the first month, so that his brain can adapt quicker. By the time the appointment was over Brandt was already understanding speech, with just the processor, WITH HIS EYES CLOSED!! This was only an hour since activation.
Over the next day and a half, he seemed to be understanding me better than he could with his hearing aids. He would randomly close his eyes, stick his finger in his other ear, and say, "Ask me a question." I asked things like "What is your favorite color?," "When did you graduate high school?," "What did you have for breakfast?," etc. and he understood me every time. I was having to repeat myself less often than I was used to. We were stunned. He said that I still sounded robotic and monotone, but he could understand me. And surprisingly, he doesn't hate it.
October 10: Activation, Part 2
We returned to the CI clinic two days later for "Part 2" of the activation. Brandt had already moved up to the fifth (loudest) program on the processor and said the volume was comfortable. Beth asked about sounds and he said that breathing and eating are "distracting," the microwave beeping has a "lower pitch than it used to," and strangely the only sound that hasn't changed at all is our cats' water fountain.
We told Beth how well he was doing, that he could understand me even with his eyes closed and seemed to be doing better than with hearing aids. She said, "So far, this is a really good sign." But she also cautioned us to stay guarded, because we still have a LONG journey ahead. She encouraged us to talk to each other a lot so he gets more practice with communication, and for Brandt to watch television with captioning and try to focus on listening to the dialogue.
October 16: 1 Week Post-Activation
I was very anxious to see how Brandt was going to perform in the sound booth. Knowing that it takes quite a while to get all the fine-tuning done, I kept my expectations low (the theme of this month). I figured he would miss about 75% of the words. I was shocked when he correctly repeated back each of the words Beth said: mousetrap, birthday, school bus, railroad. I did a little happy dance in my seat. Then she started reading off more words, but at a lower volume. Uh-oh, I thought. He won't be able to hear any of those, they're too soft. But he proved me wrong, he got every single one again. Then she dropped the volume again. Still got them all correct. I burst into tears. The volume dropped yet again and he got about half, but it was so quiet that I had to strain to understand them. I was trying not to make any noise because I didn't want to distract him, so when Beth opened the sound booth door, I had my hand over my mouth as my shoulders shook silently. Brandt turned around to look at me and thought I was suppressing laughter. He said, "I must have done really bad if you're laughing at me." I wiped my eyes and explained that NO I wasn't laughing, I was bawling because he did so unbelievably well!
Back in Beth's office, she told us that she is "very pleased" and compared his performance from today to how he did a year ago with hearing aids. Aided, he could understand the words at 35 decibels. Today, it was 25 decibels! At only one week post-activation!!
Next, Ariel came in for listening therapy. We had already done about six months of listening therapy with his hearing aids, ending in January of this year, so we knew the drill. First we worked on Ling-6 sounds: ah, oo, ee, sh, mm, ss. Then we did a vowel word list, where the first and last sound of each word is the same and only the middle vowel is different: pit, pat, pot, put, pet, pert, putt, etc. Then we added a new exercises, a list of 25 random sentences. Brandt read the sentences and then Ariel and I took turns reciting them for him to repeat back. At this point, I was no longer surprised that he did a lot better than he had with hearing aids--but I was very very happy.
We went out to dinner after the appointment to celebrate and test how well Brandt could do in a noisy restaurant. Despite the loud jazz music playing overhead, and several loud birthday parties (involving copious amounts of alcohol) around us, he did amazingly well. I was struggling to hear him sometimes but he didn't seem to have much trouble at all. Incredible!!
October 19: 11 Days Post-Activation
Tonight we did our listening therapy homework, and I know the words "amazing" and "incredible" are being severely overused lately, but I don't know what else to call it! With the Ling-6 sounds, I recited them each three times and he only missed a total of two--that's an 89%. On the vowel word lists, he got about 85%. I'm using the same notebook to record his results now that I used for our previous, hearing aid round of listening therapy, so I can compare his results. He used to get about 50% on both the Ling-6 and vowel word lists. Definitely a major improvement! Then we did a new list of 25 random sentences and he didn't miss a single word. We both sighed with relief and awe. It's like we've been holding our breath for the past five years and now, we can finally believe that maybe it's going to be okay.
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| Advanced Bionics Naida processor in Caribbean Pirate turquoise |
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