Bilateral Implants - Page 2

LadySekhmet · 05-31-2008, 08:27 AM

Well, I *know* there's been a lot of POSITIVE talks about bilaterals. All the people that I'm familiar with on this forum that has bilateral loves it.

What I want to know is if anyone had any NEGATIVE experiences with being bilateral. I do know one lady that was, but it's mainly because the first implant was kind of messed up/something's up with the electrode array...and she's working on getting that fixed. She does love her second CI though.

If there's NO negative experiences, it kind of proves that bilateral gives a lot more benefit than just having one. The issue is that the current population that has one CI, more often they're happy and satisfied with just one, and wouldn't consider of getting another.

I have 8 friends who have CI. I'm the only one that have bilateral. Few of them have reasons why they won't go through second surgery.

vallee · 05-31-2008, 09:24 AM

The only negative I can think of is that both CIs work together and the sound quality if so different with only one.

loml · 05-31-2008, 09:47 AM

Quote:

Originally Posted by vallee

The only negative I can think of is that both CIs work together and the sound quality if so different with only one.

vallee- Would you expand on this please, I do not understand how this is a negative? Thankcue. (maybe I just need more coffee

)

Cloggy · 05-31-2008, 11:34 AM

Quote:

Originally Posted by vallee

The only negative I can think of is that both CIs work together and the sound quality if so different with only one.

Sorry if I misunderstand, but this sounds like "When you are used to 2 CI's, losing one really sucks, because the quality goes down".
But that's the same with 1 CI... losing that 1 and hearing nothing probably sucks as well...

Anyway... failed to see the negative view in your post.. which is actually quite positive....

LadySekhmet · 05-31-2008, 11:39 AM

Quote:

Originally Posted by loml

vallee- Would you expand on this please, I do not understand how this is a negative? Thankcue. (maybe I just need more coffee

)

I *think* what she means is that because you have two, they both have different sound quailty, and you kind of have to work with the two.

Vallee - correct me if I'm wrong..I have NO idea what it's like...yet!

Cloggy · 05-31-2008, 11:42 AM

Quote:

Originally Posted by LadySekhmet

Well, I *know* there's been a lot of POSITIVE talks about bilaterals. All the people that I'm familiar with on this forum that has bilateral loves it.

What I want to know is if anyone had any NEGATIVE experiences with being bilateral. I do know one lady that was, but it's mainly because the first implant was kind of messed up/something's up with the electrode array...and she's working on getting that fixed. She does love her second CI though.

If there's NO negative experiences, it kind of proves that bilateral gives a lot more benefit than just having one. The issue is that the current population that has one CI, more often they're happy and satisfied with just one, and wouldn't consider of getting another.

I have 8 friends who have CI. I'm the only one that have bilateral. Few of them have reasons why they won't go through second surgery.

You're right.. there should be some negative experiences, but from what I hear the negative experiences generally have to do with cost. Because, if it is not covered by insurance, it is very expensive. Also, more equipment, battery-cost and other issues (cost of any possible failure) I'm sure.

Check with your friends.. Why don't they consider another CI? Perhaps cost, but perhaps the step from deafness to hearing sounds is so huge, that imagining another step upwards is too big to conceive.. And when one does not have bi-lateral experiences around you, how should you know the additional benefit.
Looking forward to hear how they think..

darkangel8603 · 05-31-2008, 12:42 PM

Quote:

Originally Posted by deafdyke

Oceanbreeze, I guess the matter won't be settled until someone does a survey of the CI populution. It's really hard to tell thou, since it's pretty much a fact that two people with the same audiogram can respond very differently to different hearing technologies.
kim, could it be that they only have bilateral CI for specific popultions?
darkangel.......quick question. Are you working with an audi who has extensive experiance with the pediatric dhh popultion? And it does kinda suck that you couldn't get a second CI easily, but at least you're getting a ton of benifit from your first one!

humm I'm not too sure about that, but i would think she does, she works with both children and adults.

deafdyke · 05-31-2008, 03:03 PM

Darkangel, is there any way that you could see an audi who is affliated with a School for the Deaf? You know......someone who is very very familair with the pediatric dhh population, and might know of tips and tricks and things that a general audi wouldn't. You know......even if a traditional HA doesn't and hasn't really given you a lot of benifit, you might want to see if the more nontraditional "HAs" might help you a bit. By nontraditional, I mean things like the ImpAct aid and maybe even a tactile aid.

LadySekhmet · 05-31-2008, 03:47 PM

Quote:

Originally Posted by Cloggy

Check with your friends.. Why don't they consider another CI? Perhaps cost, but perhaps the step from deafness to hearing sounds is so huge, that imagining another step upwards is too big to conceive.. And when one does not have bi-lateral experiences around you, how should you know the additional benefit.
Looking forward to hear how they think..

Two of them feel that one is enough. One refused to "get her head cracked open", and blames on the fact that she's on immune-suppressant drugs hindering her (which is kind of a valid reason but still the first comment?), One doesn't really use her CI that much anyways...she just wanted a taste of having a CI. I haven't really talked to the others, so I can't tell you why they won't consider it. I'm the only one out of all of them (not to be an egoist), that is more excited about CI and learning the history of CI, learning other people's experiences, and have my own blog about CI journey. The others feel "it's just another device". Make sense?

darkangel8603 · 05-31-2008, 04:10 PM

Quote:

Originally Posted by deafdyke

Darkangel, is there any way that you could see an audi who is affliated with a School for the Deaf? You know......someone who is very very familair with the pediatric dhh population, and might know of tips and tricks and things that a general audi wouldn't. You know......even if a traditional HA doesn't and hasn't really given you a lot of benifit, you might want to see if the more nontraditional "HAs" might help you a bit. By nontraditional, I mean things like the ImpAct aid and maybe even a tactile aid.

I don't think so, isn't pediatric for children? I am not in school anymore so i doubt an audi from school for the deaf would be able to do anything, not only that there is a real shortage of audi at deaf schools in ontario. in fact i havent even seen one audi at school when i was there for hte last 10 yrs

Hear Again · 05-31-2008, 07:06 PM

Quote:

Originally Posted by LadySekhmet

I *think* what she means is that because you have two, they both have different sound quailty, and you kind of have to work with the two.

Vallee - correct me if I'm wrong..I have NO idea what it's like...yet!

This is what I gathered from Vallee's post as well. By the way, my CIs sound vastly different (my first CI has more "bass" while my second has more "treble"), so I can understand where this would be considered somewhat of a negative. In my case, I understand speech much better with my right CI compared to my left.

loml · 05-31-2008, 07:41 PM

Quote:

Originally Posted by Hear Again

This is what I gathered from Vallee's post as well. By the way, my CIs sound vastly different (my first CI has more "bass" while my second has more "treble"), so I can understand where this would be considered somewhat of a negative. In my case, I understand speech much better with my right CI compared to my left.

Hear Again - How very interesting. I thought the "bass" and "treble" difference could/would of been modified with mapping to be the "same." I suppose it depends on what your losses were in each ear prior?? Was there a difference in reception between both ears prior to your CI's?

Hear Again · 05-31-2008, 08:18 PM

Quote:

Originally Posted by loml

Hear Again - How very interesting. I thought the "bass" and "treble" difference could/would of been modified with mapping to be the "same." I suppose it depends on what your losses were in each ear prior?? Was there a difference in reception between both ears prior to your CI's?

My audi and I have tried to balance out the sound of both CIs, but no matter what programming changes are made, I still end up with my left CI sounding more "bassy" than my right. I suspect that one of the reasons for the discrepancy is because my right CI is utilizing slightly newer technology than my left. Another strange experience I have is of sound seeming to come from the right side of my head (instead of being centered) if that makes any sense.

My right ear has always been my "better" ear and my speech discrimination was much better with the right ear compared to the left pre-CI. With my left ear, I could only hear vowel sounds, but with my right ear, I could hear some consonants even though I couldn't identify what they were.

I'd be curious to know about the experiences of others in regards to how each of their implants sound as well as whether or not the sounds they hear are centered or seem to be coming from the left or right side of their head.

Hear Again · 05-31-2008, 08:46 PM

One thing I haven't done yet is to experiment with different speeds and speech strategies such as SPEAK and CIS. That might be something for me to consider with my left CI since it might help make sounds more balanced between both CIs. Now that I think of it, the only experimentation I've done was to use ACE at 720 (?) Hz which only resulted in everything sounding extremely high pitched and indecipherable. At the moment I'm using ACE at 900 Hz with both CIs. Interestingly enough, I do have trouble hearing in background noise even though I'm bilateral. My audi referred me to an SLP for aural rehab, but she (the SLP) doesn't know how she can help me since I'm totally blind. (However, the SLP promised to do some research and get back to me in regards to some tactics I could use to improve my ability to hear in noise.) Perhaps I can kill two birds with one stone (improve my ability to hear with my left CI and hear in background noise) by making changes to my left CI so that both sound the "same." My CI audi has told me what ultimately counts is how well I'm able to hear with both CIs, but my booth testing (98% HINT) does not correspond to real world experience.

LadySekhmet · 05-31-2008, 09:27 PM

Quote:

Originally Posted by Hear Again

One thing I haven't done yet is to experiment with different speeds and speech strategies such as SPEAK and CIS.

Interesting. I never tried SPEAK, only ACE. To me, everything sounded normal, and if not, much better than my hearing aids. So I have no idea what SPEAK is like. However, CIS may be out of the question for you because it's made for those CI users that has partial electrode array implantation due to ossification. Even though Freedom has 24 (there are 24, but 2 is not used in almost all cases, hence why 22 is used), if someone only has partial implantation, they can use 12 electrodes, and use the CIS strategy, and have it perform as if it's 22 electrodes. So that's kind of all I know with CIS.

I totally agree that audio booths are different than real world. I am able to hear on the 10db line - yes, better than hearing people. However, when I'm out in the real world, I do have a bit difficulty filtering out sounds, background noises that hearing people have no problems with.

Have you ever consider of asking your audi to have a portable computer (my audi uses the programs on a laptop), and have it attached to you while you're out at a mall, or a slightly noisy place, or whatever. Maybe that can help a little bit? I just wished there was some way that audis can realize that booths and rooms does not make up for what you hear in the real world.

loml · 05-31-2008, 10:05 PM

Hear Again

Quote:

Interestingly enough, I do have trouble hearing in background noise even though I'm bilateral

LadySekhmet

Quote:

However, when I'm out in the real world, I do have a bit difficulty filtering out sounds, background noises that hearing people have no problems with.

Hear Again & LadySekhmet - I wonder if it has to do with how familair the sound(s) are? I know in my experience as a hearing person, there are certain noises; ie. living by a railway, that I "filter" out after period of time hearing it: as if that sound(s) is/are of no consequence.

I also know for myself, if the tv is on, as well as the stereo ....my brain says okay, okay one or the other please.

Hear Again · 05-31-2008, 10:06 PM

Quote:

Originally Posted by LadySekhmet

Interesting. I never tried SPEAK, only ACE. To me, everything sounded normal, and if not, much better than my hearing aids. So I have no idea what SPEAK is like.

I can say the same thing about my CIs with the exception of a few voices I have difficulty understanding. I primarily have difficulty understanding female voices or accents and a much easier time understanding male voices. (That was the same 6 years prior to implantation when I used an FM system.) When the SLP asked me how much I thought my life improved due to my CIs in terms of percentage, I said 50% because that's the honest truth. Don't get me wrong. I *love* my CIs, but I still find myself struggling to hear from time to time -- especially in noisy enviroments. I don't know...perhaps I was really, really excited pre-CI by those who said they could hear in a noisy restaurant at a table of 10. That's something I can't do. Sometimes I even have difficulty hearing the person next to me depending on their vocal quality and the overall level of background noise. I guess I expected to be able to hear better in background noise than I do. I don't have *any* regrets about getting CIs, but if I'm completely honest with myself, I *know* I'm not hearing as well as I expected to especially in noisy environments. Would I go back to wearing HAs if I could? No way. That might sound like a contradiction to what I've written here, but again I guess I expected to be able to understand female voices, accents and hear better in background noise than I presently do.

I totally agree that audio booths are different than real world. I am able to hear on the 10db line - yes, better than hearing people. However, when I'm out in the real world, I do have a bit difficulty filtering out sounds, background noises that hearing people have no problems with.

Do you hear only low frequencies at the 10 dB line or do you hear at 10 dB across the board? I was recently tested and scored at the 15 dB line for low frequencies and 20-30 dB for mid and high frequencies. This might explain why I have more difficulty hearing female voices compared to male. When I think about it sometimes it seems like I presently function as if I have a moderate hearing loss in regards to my ability to hear in noise as well as female voices/accents. I know I shouldn't complain because that's obviously much better than trying to function with a severe-profound loss, but I guess my expectations in that area were unrealistic.

Have you ever consider of asking your audi to have a portable computer (my audi uses the programs on a laptop), and have it attached to you while you're out at a mall, or a slightly noisy place, or whatever. Maybe that can help a little bit? I just wished there was some way that audis can realize that booths and rooms does not make up for what you hear in the real world.

I do too! Your suggestion of a portable computer is a good one and something I'll have to ask my audi about. If that's not possible, one thing I know we could do would be to go out into the waiting room and conduct the mapping there since my CI center is located at a large hospital.

e

Hear Again · 05-31-2008, 10:18 PM

Quote:

Originally Posted by loml

Hear Again

LadySekhmet

Hear Again & LadySekhmet - I wonder if it has to do with how familair the sound(s) are? I know in my experience as a hearing person, there are certain noises; ie. living by a railway, that I "filter" out after period of time hearing it: as if that sound(s) is/are of no consequence.

I also know for myself, if the tv is on, as well as the stereo ....my brain says okay, okay one or the other please.

That could very well be the case.

I also notice that one thing I still have trouble with is focusing on whatever it is I want to listen to. Prior to receiving my first CI, I used alternative communication techniques for the deafblind (tactile sign, Braille real-time captioning, etc.) for 4 years which means that I didn't actively use my hearing during all that time. 6 years prior to that I used an FM system, but could only listen for short periods of time before exhaustion would set in.

Fast foward to today...it's easy for me to "zone out" and I have to force myself to concentrate on whatever it is I'm listening to. I also notice that sometimes no matter how many audiobooks or podcasts I listen to or how long I practice, some voices (female, accents) just do not come through clearly enough for them to be understood.

loml · 05-31-2008, 10:26 PM

Hear Again - There are some accents that I just don't get either. I do a lot of "pardon me"?

I think it would be safe to say that our brains are "tuned/wired" to hear certain accents, say mid-western US or for me western Canada. Perhaps this is similiar with when you have a mapping sessions, as the audi is familiar with certain dialects/accents. Is this making sense?

Not that this is about CI's, but when some hearing people learn to cue, and they are from a different region or country than I, they cannot "hear" certain sounds. It is al so very interesting.

deafdyke · 05-31-2008, 10:48 PM

Well pediatric is for kids, but I don't think theres anything as specialized as a pediatric audi. The reason why I suggested seeing an audi at the Deaf school, is that they would have seen more people who have been dhh since childhood. Like just a general audi, would have most of their experiance with the population that is late dhh. Make sense?
And I would ask your audi if she thinks that you might benifit from things like Impact or frequncy transposition or even tactile aids.

deafdyke · 06-01-2008, 03:14 AM

Again, just to clarify I'm not against bilateral CIs. However, this conversation that we're having brings up a good question.....where shoud the dividing line be between CI and HA use? I know that doctors have to follow FDA guidelines. However, it does seem that in some cases, people are taking undue advantage of wiggle room.
There's nothing at ALL wrong with implanting someone with auditory nereopathy or who doesn't get ANY benifits from HA, or has severe recruitment or tinititas. Or even someone with an uneven loss.....where one ear responds well to aiding, and the other is "dead"
Those folks should get implanted. However, it's a fact that you can get implanted as an adult, when you can hear 60% of speech. FDA isn't as strict about the hearing little to no speech, threshold as they used to be in the past.
The bilateral debate so far has ignored that fact. 60% with an aid is nothing to sneeze at! That's pretty good actually. I mean wouldn't it work in conjunction with the input from a the CI?
As I've said before, there's nothing wrong with bilateral implants, if there's nothing else that works. If the person' shows a clear canidacy , IMPLANT them bilaterally.
I remember ten years ago when digital aids first became the rage......the same thing happened. Everyone was "Digital aids, digital aids!" All Volta Voices articles were about the wonder and glory of digital aids.
Yet there were/ are still many people who use analogs

You know...........maybe a good idea might be to make the canidacy for a second CI, a lot stricter then the first. I know I get jumped on b/c I insistutated that some people are opting for CI b/c its "trendy"
However, it does seem like there is a population of people who absolutly positively need the latest hearing technology, and are abusing the "wiggle room" in order to get it. Yes, I'm aware that sound is fuller for the bilateral implantees out there, but in some cases a traditional HA or things like a tactile aid or Impact aids, might do the trick. See what I mean?
.

ismi · 06-01-2008, 06:47 AM

As one of those people who had 'borderline' speech perception in real-world (non-testing) situations, I'm just going to reiterate that you really don't know what you're talking about. You of all people should know that there's a huge difference between being able to cope with spoken language, and being comfortable using it on a daily basis.

So if that's the difference, then why not? Similarly, if going from one CI to two is the difference between being 'functionally HOH' (as you're so fond of saying) and being substantially less HOH, what's the problem? Particularly since the criteria on which every audiologist I've ever spoken to bases their decision is similar between "no CI to one CI" and "one CI to two".

The fact that you keep suggesting that tactile HAs and the Impact are equivalent to a CI is just further evidence that you haven't really thought this through. You're not an audiologist; you're not a CI user. And your posts don't show that you've done any real research or thinking about CIs. Until you have something new to say ... please do us all a favor and quit rehashing the same (repeatedly refuted) talking points.

vallee · 06-01-2008, 06:58 AM

Quote:

Originally Posted by LadySekhmet

05-31-2008, 08:27 AM	#31 (permalink)
LadySekhmet Cyborg Queen Join Date: Sep 2007 Location: Las Vegas! Posts: 450	Well, I know there's been a lot of POSITIVE talks about bilaterals. All the people that I'm familiar with on this forum that has bilateral loves it. What I want to know is if anyone had any NEGATIVE experiences with being bilateral. I do know one lady that was, but it's mainly because the first implant was kind of messed up/something's up with the electrode array...and she's working on getting that fixed. She does love her second CI though. If there's NO negative experiences, it kind of proves that bilateral gives a lot more benefit than just having one. The issue is that the current population that has one CI, more often they're happy and satisfied with just one, and wouldn't consider of getting another. I have 8 friends who have CI. I'm the only one that have bilateral. Few of them have reasons why they won't go through second surgery. __________________ LEFT: Implanted: 1/10/08 with Freedom Implant Activated: 2/1/08 Freedom RIGHT: Implanted: 5/15/08 with Freedom Implant Activated: 6/13/08 Freedom http://cyborgqueen.blogspot.com

05-31-2008, 09:24 AM	#32 (permalink)
vallee Registered User Join Date: Aug 2007 Location: Tennessee Posts: 968	The only negative I can think of is that both CIs work together and the sound quality if so different with only one. __________________ Right and Left Implanted July 19, 2007 Activated August 9, 2007 Both Advanced Bionics Harmony http://talesfromacigal.blogspot.com/

05-31-2008, 08:46 PM	#44 (permalink)
Hear Again Registered User Join Date: Jan 2005 Location: Wisconsin Posts: 1,927	One thing I haven't done yet is to experiment with different speeds and speech strategies such as SPEAK and CIS. That might be something for me to consider with my left CI since it might help make sounds more balanced between both CIs. Now that I think of it, the only experimentation I've done was to use ACE at 720 (?) Hz which only resulted in everything sounding extremely high pitched and indecipherable. At the moment I'm using ACE at 900 Hz with both CIs. Interestingly enough, I do have trouble hearing in background noise even though I'm bilateral. My audi referred me to an SLP for aural rehab, but she (the SLP) doesn't know how she can help me since I'm totally blind. (However, the SLP promised to do some research and get back to me in regards to some tactics I could use to improve my ability to hear in noise.) Perhaps I can kill two birds with one stone (improve my ability to hear with my left CI and hear in background noise) by making changes to my left CI so that both sound the "same." My CI audi has told me what ultimately counts is how well I'm able to hear with both CIs, but my booth testing (98% HINT) does not correspond to real world experience. __________________ Hear Again Left ear - Nucleus 24 Contour Advance with Freedom BTE Implanted: 12/22/04 Activated: 1/18/05 Right ear - Nucleus Freedom Implanted: 2/1/06 Activated: 3/1/06 Deafblind/Postlingual

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05-31-2008, 03:03 PM	#38 (permalink)
deafdyke So NOT a Princess! Join Date: Mar 2003 Location: Trebekistan Posts: 6,438	Darkangel, is there any way that you could see an audi who is affliated with a School for the Deaf? You know......someone who is very very familair with the pediatric dhh population, and might know of tips and tricks and things that a general audi wouldn't. You know......even if a traditional HA doesn't and hasn't really given you a lot of benifit, you might want to see if the more nontraditional "HAs" might help you a bit. By nontraditional, I mean things like the ImpAct aid and maybe even a tactile aid.

05-31-2008, 10:48 PM	#50 (permalink)
deafdyke So NOT a Princess! Join Date: Mar 2003 Location: Trebekistan Posts: 6,438	Well pediatric is for kids, but I don't think theres anything as specialized as a pediatric audi. The reason why I suggested seeing an audi at the Deaf school, is that they would have seen more people who have been dhh since childhood. Like just a general audi, would have most of their experiance with the population that is late dhh. Make sense? And I would ask your audi if she thinks that you might benifit from things like Impact or frequncy transposition or even tactile aids.

06-01-2008, 03:14 AM	#51 (permalink)
deafdyke So NOT a Princess! Join Date: Mar 2003 Location: Trebekistan Posts: 6,438	Again, just to clarify I'm not against bilateral CIs. However, this conversation that we're having brings up a good question.....where shoud the dividing line be between CI and HA use? I know that doctors have to follow FDA guidelines. However, it does seem that in some cases, people are taking undue advantage of wiggle room. There's nothing at ALL wrong with implanting someone with auditory nereopathy or who doesn't get ANY benifits from HA, or has severe recruitment or tinititas. Or even someone with an uneven loss.....where one ear responds well to aiding, and the other is "dead" Those folks should get implanted. However, it's a fact that you can get implanted as an adult, when you can hear 60% of speech. FDA isn't as strict about the hearing little to no speech, threshold as they used to be in the past. The bilateral debate so far has ignored that fact. 60% with an aid is nothing to sneeze at! That's pretty good actually. I mean wouldn't it work in conjunction with the input from a the CI? As I've said before, there's nothing wrong with bilateral implants, if there's nothing else that works. If the person' shows a clear canidacy , IMPLANT them bilaterally. I remember ten years ago when digital aids first became the rage......the same thing happened. Everyone was "Digital aids, digital aids!" All Volta Voices articles were about the wonder and glory of digital aids. Yet there were/ are still many people who use analogs You know...........maybe a good idea might be to make the canidacy for a second CI, a lot stricter then the first. I know I get jumped on b/c I insistutated that some people are opting for CI b/c its "trendy" However, it does seem like there is a population of people who absolutly positively need the latest hearing technology, and are abusing the "wiggle room" in order to get it. Yes, I'm aware that sound is fuller for the bilateral implantees out there, but in some cases a traditional HA or things like a tactile aid or Impact aids, might do the trick. See what I mean? .

06-01-2008, 06:47 AM	#52 (permalink)
ismi Implanted 7/18/07 Join Date: Jan 2006 Posts: 749	As one of those people who had 'borderline' speech perception in real-world (non-testing) situations, I'm just going to reiterate that you really don't know what you're talking about. You of all people should know that there's a huge difference between being able to cope with spoken language, and being comfortable using it on a daily basis. So if that's the difference, then why not? Similarly, if going from one CI to two is the difference between being 'functionally HOH' (as you're so fond of saying) and being substantially less HOH, what's the problem? Particularly since the criteria on which every audiologist I've ever spoken to bases their decision is similar between "no CI to one CI" and "one CI to two". The fact that you keep suggesting that tactile HAs and the Impact are equivalent to a CI is just further evidence that you haven't really thought this through. You're not an audiologist; you're not a CI user. And your posts don't show that you've done any real research or thinking about CIs. Until you have something new to say ... please do us all a favor and quit rehashing the same (repeatedly refuted) talking points.