melissa

...and tell me what it means- do I really have 'near normal' hearing in the 'speech frequencies' as I've been told- if so, why do I have so much trouble without my hearing aids, asking people to repeat things all the time? Why do I still have trouble WITH them? Do I have an unusual sort of loss? It's sensorineural after being born prematurely.

I've never been told much about audiograms, except that a 'normal' (my emphasis) person would be around 0-10 db for the whole chart, I think. I have looked online and know what db loss = mild/moderate/severe/profound etc.

Applying the info from here
Audiology Awareness Campaign: How to Read an Audiogram
tells me that, at the following freqs:

I am working from an old audiogram before I got my digital aids, from '98, and there is no value under 125hz. It's the most recent one I can find as anything after that would be on the computers at the hospital and I didn't get copies.

250 Hz: 45 and 50 dB (R, L ear in that order)- moderate loss
500: 30 and 20 (R/L) -mild
1000: 10 and 10 (R/L) -'normal'
2000: Above 0 for R ear (I don't understand this! Looks like it's about a 3db), around 3 loss for L ear -'normal'
4000: 65 and 80 (R/L) -moderately severe/severe
6000: 85 and 95 (R/L) -severe/profound
8000: 73 and 90 (R/L) -severe

In the background of the graph is a shaded area with different letters on- I assume this is the 'speech banana' I've read about on here. Now, seeing as my 'best' results/least lossy areas are the letters m, n, ng, aw, ah, ay, ee, d, t, does this mean that they are more commonly used in hearing english than f, th, and s where I have a far greater loss, and that's why I was told I have 'near normal' hearing at 'speech frequencies'- or is it just that I don't know what everyone else is hearing so I don't know I'm missing it?
Apologies if this is in the wrong place, but I've recently become curious about the intricacies of my hearing, and what it is that I'm not hearing, that people without hearing loss can hear.

I'm aware that this is very long, thankyou for reading! Most of my life I've tried to brush off my hearing loss and pretend it doesn't exist, but I've been going through a lot of (psychological) changes lately and I think I should start accepting myself as I am. Which requires some sort of understanding beyond 'I can't hear high pitched sounds well', for me at least.

Melissa,

Deafness

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deafdude1

Let me consider some points. I also created your audiogram for you.

1. 0-10db is normal hearing for a child. 10-20db is normal for an adult. 25db is "borderline" and above 25db represents a hearing loss that may benefit from HAs.

2. Your unusual, reverse cookiebite audiogram suggests you have cochlear dead regions above 2000Hz. You may also have cochlear dead regions at or below 250Hz as well.

3. The low frequencies are very important for speech and account for more than half of all speech. Unaided, you are outside the speech banana in the lows. Aided, it may be helping somewhat in the lows.

4. Your loss is very difficult to fit and HAs may be overamplifying your mid frequencies where your hearing is normal. Your highs may be dead and no HA could help except transposition which might give you a 10% improvement in speech.

I was wondering how much speech you understand unaided and aided and how good are you at reading lips?

http://www.alldeaf.com/hearing-aids-...ead-spots.html

This is a good read on cochlear dead zones. You should get tested for this then you can have HAs that are correctly programmed around your dead zones.

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melissa

Gosh, thankyou so much for your help!

I have never heard of cochlear dead zones. I'm checking out a few of the links you mentioned.

I don't know if it's just my imagination but since I have been wearing aids regularly (digital since 2006), when I don't wear them for some reason (shower, ears hurting, ran out of batteries etc) it's much more frustrating and harder for me to hear things, versus the period from when I was 16-21 when I stopped wearing my analogue aids and didn't use anything.

Unaided- well, I guess it's subjective, really- does 'hearing' mean 1st time someone says something, I hear it clearly with no problems- cos that depends on the situation. I would have to ask someone to repeat things many times during a conversation, and be facing them and lip-reading. At a bar/pub I would have almost no chance of following conversation, apart from hearing the odd word. I would have to have subtitles on the TV unless I turned it up to what I would consider quite loud. Plurals would be a big problem- not much chance of me hearing the 's' on the end of something unless I'm lipreading and it fits in the context of the conversation. The discrimination scores from my tests at school (included on the old audiogram record) are 97% unaided, but this was in a virtually silent room with a reader who sat a foot away from speaking extremely clearly and enunciating, and that's not real life! Aided was 100% but again I'm not catching things 100% of the time IRL.

Aided- I hear better in general but still have to ask for repeats in conversation several times. I am not working at the moment and neither is my mum, so we spend a few hours a day in close conversation- same room, lipreading, sat about 10 feet away. At a bar/pub, it is very difficult to follow what's being said. I don't have to use subtitles all the time, I think I've got into the habit of it though because I can't predict which words I'm going to hear and which words I won't hear properly. Plurals are still very difficult, I ask for clarification, or just guess depending on the situation.

There is a distinction between hearing and understanding, though, and often I can hear a sound when someone is talking, but they might as well be talking Martian. I lip-read most of the time and ask people to face me. I can manage without lip-reading if someone speaks clearly in a quiet room and I'm familiar with the topic of conversation, or they're a very loud person in a mildly noisy environment.

It's interesting to learn what you said about being outside the speech banana in the lows- I was always under the impression, from what the special needs staff/audiologists said to me, that most of my hearing of speech was normal, and any loss in hearing speech was only mild- that it was just high frequency sounds I wouldn't hear. It was never explained what correlates to these frequencies IRL though, I'm not going around trying to hear dog whistles. Having said that I've always had a lot of guilt about wearing/not wearing aids- it's mild so I shouldn't need them, but I frustrate people so much asking for repeats..then I decided to bite the bullet and get digitals, and I feel as if I should be able to manage without them.

I didn't realise how many accommodations I make until I had to describe them all. My dad likes to say a certain phrase- people not hearing correctly/making assumptions about what they hear is how 'Send six and four-pence, we're going to a dance' gets turned into 'Send reinforcements, we're going to advance.' I would say that describes me perfectly!

I'm currently wearing Unison 6 BTEs, I don't know if they transpose. I got plugged into a machine and heard lots of beeps (technical!) which I gather was customizing it to my loss. Basically I went to the audiologist and said I'd like to try hearing aids again and that I'd heard (pardon the pun) good things about digital aids. Not sure where you live but I'm in England so its free on the NHS, but I didn't get a choice of any kind.

Melissa

P.S. What sort of hearing loss is 'usual'? I'm not being sarcastic, I just always thought that everyone with hearing loss heard the way I did.

souggy

Most people's hearing loss are not a cookie-bite like yours.

Most slope downward from left to right, like in deafdude1's signature.

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Warning! Contains skewed comments & inane ramblings. May cause spontaneous human combustion

melissa

Thanks :-) I'm interested to know what that means, though, for someone's life- is it easier for 'most people' with hearing loss to hear plurals on the end of words? I get mixed up with rhyming words and have to guess depending on the context, but I thought everyone with hearing loss had the same problem. Deafdudes loss is more severe than mine, though, so maybe that's what accounts for whatever 'symptons' people will have?

souggy- I just saw that your avatar area says 'The Deaf Philosopher'- I did an English Literature/Philosophy degree at Keele uni in the UK (near where I live). Just had a look at your blog- some interesting things to consider about how I, or others, label myself.

Although I protest against labelling, I do want to know what I am 'considered', I suppose in an attempt to find somewhere to fit in. How would you describe my hearing loss after seeing my audiogram? As I have always been told 'mild', I say to people 'I wear hearing aids, I have mild hearing loss but problems hearing high-pitched sounds.' Then again I didn't realise the low frequency loss was that relevant to hearing speech- I think I need to look at the speech banana again.

Incidentally- hope it's not TMI, I visit a therapist (as in psychologist, for personal issues) and we discussed my fear of talking to cashiers in shops and not being able to hear what they say when they tell me the total (I usually hand over a big note or pay with plastic). She suggested that perhaps I'm not accepting that I have hearing loss...I have always been able to say that I do, but this is the first time I'm considering that it actually has a big effect on my life. I brush it off as 'mild' then just beat myself up for not paying more attention to people- if I can hear them sometimes, but not other times, it feels like I'm not 'listening hard enough'.

Geez, talk about guilt!!

souggy

Speech banana (not my audiogram, something I snagged from Google):



Most deaf people can't hear s-, ph/f, th, sh and so on.

I am not much for labelling, but if it help other people understand... without having to go into lengthy explanation... so be it.

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deafdude1

Im still learning about those as well. I believe my cochlea is dead to speech above 600Hz and dead to sound above 1200Hz. It doesn't matter how my HAs are programmed above 600Hz, even if all gain was turned off my speech stays the same. Turn the gain at 600Hz and below down and my speech goes way down.

Perhaps your hearing got worse? The audiogram you show is an old one. See if your audiologist can email or fax all your recent audiograms, they have to.

Ok, what % do you understand the first time without repeats and without reading lips? How much higher is it when aided?

Yea the lows you are missing affect the loudness alot. With the gains turned off on my mids, things became somewhat less loud but clarity was unaffected. With the gains turned off on the lows, things became quiet and I heard only a few environmental sounds and no speech.


I believe you. I can understand over 50% of what my dad says in near ideal conditions too. I do wonder why you can't hear the S and my dad can. My dad is still outside the speech banana for high frequencies, including S and F yet he hears both easily. It's possible your hearing is considerably worse than it was back then.

I am the same way except I don't score as high on speech as you in any setting. I relay almost totally on lipreading but can understand 80% of the converstation that way. How about you?

Having said that I've always had a lot of guilt about wearing/not wearing aids- it's mild so I shouldn't need them, but I frustrate people so much asking for repeats..then I decided to bite the bullet and get digitals, and I feel as if I should be able to manage without them.

I could manage without HAs since I relay on lipreading but HAs give me access to environmental sounds, without them I live in a silent world. Are sounds loud enough for you without HAs?

Sloping losses make up 90% of audiograms. Hearing starts high at 250Hz and slopes down till it's low or none at 8000Hz.

No, for most people vowels are the easiest to hear. I scored 4% last time I took an unaided speech test, I basically heard only vowels.

I hear with HAs much worse than you hear unaided. Based on your old audiogram, you hear unaided better than even those with CI!

Based on your old audiogram, a mild loss fits you. For me, a severe-profound loss fits me, but in reality my loss is profound in most frequenices.

Incidentally- hope it's not TMI, I visit a therapist (as in psychologist, for personal issues) and we discussed my fear of talking to cashiers in shops and not being able to hear what they say when they tell me the total (I usually hand over a big note or pay with plastic). She suggested that perhaps I'm not accepting that I have hearing loss...I have always been able to say that I do, but this is the first time I'm considering that it actually has a big effect on my life. I brush it off as 'mild' then just beat myself up for not paying more attention to people- if I can hear them sometimes, but not other times, it feels like I'm not 'listening hard enough'. Geez, talk about guilt!!

I don't even try actually hearing, it's 10x easier to just read lips and I ask for repeats on whatever I missed. I accept my deafness but would still like stem cells so I can hear better. I discussed this in the stem cell thread and on my blog. Id like to chat to you on instant messenger someday, you may post that as a comment in my blog(click on my audiogram in sig)

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faire_jour

I would never ever say that your loss is mild!!! You are severe-profound in the high frequencies. And despite what Deafdude says, that is where most of speech understanding takes place.

Has your loss always been stable?

(Oh, and you hear better in a very narrow range, better than those with a CI. You will come to see that Deafdude is anti-CI, but nearing delusionally positive about stem cells, which are no where close to tested, proven or shown to be useful in people.)

Bottesini

Speech is at 6000 to 8000? That is the only severe area on her audiogram that I see.

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It's a joke Nathan!

faire_jour

Yes. TH, S, and F sounds are all above 4000 hz.

deafdude1

My dad has a moderate hearing loss above 2000Hz and hears all those letters just fine. I hear letters that take place at 1000Hz to 2000Hz despite my cochlea being dead to speech above 600Hz, even with my HA gain set to 0 above 600Hz, I still hear mid frequency letters. That's because those letters may peak at 2000Hz but their energy ranges from 300Hz to 4000Hz. The letter S is not a puretone, while it's energy may peak at 4000Hz, it's energy ranges from 750Hz to 8000Hz. My dad is able to hear the 750Hz to 2000Hz components of the letter S(and F) which is still enough to make the S audible to him.

She scores 97% speech unaided and 100% aided. I could not come anywhere close with CI. Her high frequency hearing loss has not prevented her from scoring this high. Even Miss Kat was scoring 86% with CI programmed to about 20db across the audiogram, but that is very good for CI.

Speaking of speech understanding, I know a woman who hears at 10db at 250Hz(and below) 50db at 500Hz, 100db at 750Hz, nothing above that and she scores 58% speech and can understand some speech using phones. That's because she has normal hearing in the low frequencies. I can understand over 50% of what my dad says without lipreading because my HAs aid me to 10db at 250Hz. Yesterday in the car, dad said numbers such as "five hundred twenty six" and I got most of them correct and that's with lots of background noise.

Her pure tone average(PTA 500, 1000, 2000Hz) is 10db HL! Very few get to 10db PTA with CI and even those that do, it doesn't come close to the quality of 10db unaided hearing! I will agree that those with CI do hear better than she does above 2000Hz, however she should try transpositional HAs for maybe a 10% boost in speech in certain situations. Overall, she hears unaided way better than CI. Aided, she would hear way better than CI at every frequency.

Nowhere have I said I am against CI except forcing it on babies and children who have residual hearing which HAs could amplify. I would force CI on my children if they had no residual hearing. As for stem cells, I have already seen proof of it working in people. I am getting stem cells in about 3 years which should improve my hearing from 110db(PTA) to 80db(PTA) then with HAs set to maximum gain/amplification ill be aided to 10db(PTA) this is way better than the majority of those with CI. Ive explained stem cells in detail in my blog, including all the advantages.

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faire_jour

Pure tone average is useless with a hearing loss as varied as her's is.

Where is your dad's audiogram?? What is his speech testing like? What test did they use??

Maybe YOU couldn't get those speech scores with a CI, maybe you could. We will never know because you will go to the grave waiting one more year for stem cells. But many people do get those scores with a CI.

shel90

IMO, only someone who is a trained audiologist can interpret your audiogram and answer your questions. I have some training in audiology but I don't feel I am qualified to help. Good luck.

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Shel~

"A child educated only at school is an uneducated child." -George Santayana

souggy

* angel choir *

The voice of reason!

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melissa

Oh boy...I go away for a couple of hours and I come back and have no idea what half the jargon means..I did a basic short course in audio electronics at uni (they made us pick something different to our main subjects), but I nearly failed, and I barely understand all these numbers...

As for my opinion on CI- it's never been anything I need (to my limited knowledge about it all) but it's an individual choice for those who would benefit. My general attitude to everything is- each to their own, you do what's best for you if I can do what's best for me.

F, th, ph, t, s and all those other lovely sibilants- I can hear if someone stands in front of me and clearly makes those sounds, but in general conversation they're very easy to mix up, and 'sock' might as well be 'socks', when it comes to the 'S' on the end of plurals. My mum said when I was little I said 'docks' instead (bless). Most of the time it doesn't really matter, in a conversation, but sometimes it does. The other day my mum mentioned someone by the name of Jill Glover (pronounced like 'glove' then 'er'), but she said it too fast and I heard 'Jug Lover'. It was quite perplexing for me.

faire_jour, I understand that I have severe loss in the high frequencies, but I'm not able to correlate it to 'what-things-in-the-world-make-noises-at-that frequency', apart from dog whistles or something like that. If most of the things fully hearing people encounter in their daily lives don't make noises at those frequencies, then does it really matter? Am I really missing anything? To answer your question, yes, it's always been stable- every audiogram I've had looks pretty much the same, give or take a little.

To answer some questions that were asked- are things loud enough for me without aids? Conversation is not CLEAR enough as much as loud enough, but yes, a little louder is helpful without aids. TV is ok as I have always used subtitles and can turn it up how I like. Cars, most of the time I can hear, unless it's extremely quiet/not moving- once when I was 10 I was riding my bike outside, heard a honk and turned round in shock to see a bloody great big land rover behind me wanting to get past (I lived in a narrow street). I guess it depends WHICH things- conversation needs a little more loudness/clarity, TV's manageable but difficult with no higher volume/text, birds chirping and all that sort of stuff- I'd say I can hear 80% of things like that, environmental noises, without my aids, then I put them in and I can hear the central heating system and some other, quieter chirpy birds, and general talking downstairs I didn't know was going on...I really can't put a % on things as it depends so much on the situation, background noise, if I'm tired and not lipreading...

I'm feeling a little uncomfortable, largely in part from my school years, where I was always the one with the 'better' hearing out of the kids with hearing problems, and adults said 'You barely notice', so I feel guilty for having to ask for repeats, what was that, please face me, did you say bob or job? when there are so many people who can't hear any of the things I take for granted. I guess this is why I'm asking for feedback- do I have a 'problem' or am I just not listening hard enough...the other issue is why I'm still asking for repeats a few times in a conversation with my aids- I don't know if this is to be expected, or if I need new microphone covers/tubes/a recalibration- I'm meant to go every 3 months but I'm a bit behind.

ecp

I agree, although I have dabbled in audiogram interpretation...guilty.
But I have a few years of neuroscience research experience and lots of experience doing ABRs and OTEs on mice...

deafdude1

That's why I said before that PTA has it's limitations. It doesn't take into account the lows and the highs. PTA just gives an estimate of your hearing level but for someone like me who has alot more residual hearing in the lows, I hear better than someone with a slightly better PTA than me who's missing the lows. Her PTA of 10db is not the same as my dad's slightly worse PTA.

They did not test for speech and ill have to find his audiogram, but I remember it started at 10db and sloped gradually then took a sharp drop in the high frequencies. His loss is at moderate levels above 2000Hz and outside the speech banana. He understands everything I say and can hear and differnate all the high frequency speech consonants. Ive explained that's because letters such as "S" may have peak energy at 4000Hz but it's energy takes place from 750Hz to 8000Hz and my dad can still hear part of the energy of "S" so it is still audible to him.

It would not be a realistic expectation to get the 97% speech score that Melissa was getting unaided. Miss Kat was getting 86% aided with her CI and that's very good, but then she hears above average for CI. Not everyone gets as low as 15db with CI like she did! I am getting stem cells in around 3 years, definately not waiting more than 5 years. Ill take whatever stage stem cells is by then and accept whatever improvement they give me. I know that stem cells will give me much better odds of hearing great than CI plus all the other advantages.

The fact you can still hear S, F, TH proves that those consonants aren't puretone. You are missing part of the high frequency energy, but not all. You don't hear those consonants as loudly as a hearing person. Transpositional HAs will make those consonants sound louder and stand out better. I hear consonants with peak energies above my hearing range, I just hear part of that consonant. Many words that rhyme do sound the same to me, that's why I just read lips its 10x easier and I understand 80% speech that way.

Youll find out with transpositional HAs, but I am told that only 10% of speech and sounds take place above 2000Hz so youd be missing that 10% which isn't much really. Most people find high frequency sounds annoying anyway.

Let me tell you something, when I talk to others they sometimes ask me for repeats! Even hearing people don't hear "perfect" nor do they hear "everything" it may seem like it but there are many animals who hear way better than humans(in the higher frequencies in particular)

Hearing people may score 100% speech on the easier speech tests(even you score 97%) and they may understand 100% speech in some situations, youd probably be at 80% in the same situations. In unfavorable situations, even hearing people miss half of what me and others say. It's not just you! So youll miss a little more speech than what hearing people would miss. For you, itll take a little more effort. You function without HAs similar to someone with a flat 30db HL across the audiogram. I function with HAs similar to someone with a 50db flat loss! Normal hearing for adults is 10-20db across the audiogram so you aren't far off. Hope this all helps!

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souggy

Bloody hell, deafdude1. Don't tell other people how their hearing works.

They should see an audiologist, not from some know-it-all who doesn't even have an ounce of questionably toward new technology.

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melissa

I'm starting to wish I hadn't asked! I just wanted to know more than 'I can't hear things at very high frequencies', but I think I bit off more than I can chew. I've emailed my audiologist anyway, saying I need to make an appt as I'm having more trouble lately, and do need a checkup.

souggy

Don't worry about it. Sorry your thread got derailed.

if you can't hear words at high-frequency, you can't hear them. If you're having a hard time hearing in certain situations, you are; no one have the right to tell you what you should be hearing in certain situations. Your audiogram show that you have a hearing loss.

However it is wrong for someone else compare your hearing loss to their own or to another person's. You came here to make sense of your audiogram without the excessive jargons, not to have someone compare the different type of losses.

As it stand, you are missing out on the high-frequency phonemes, and some of the low-frequency ones.

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sallylou

Welcome to AD, Melissa.

I tend to avoid threads about specific audiograms because it's not helpful to compare different kinds of hearing loss. I stick with what my audiologist says. When you get a check up, your audiologist can explain your hearing loss and make recommendations. Good luck at your check up!

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Happy holidays!

melissa

Thankyou, souggy and sallylou. I think this thread has run its' course now, it's nearly all over my head. Thankyou to everyone who has replied, despite my limited understanding of the replies!

deafdude1

If you want any further explainations, feel free to check my blog and comment there. Ive already answered you. Your audiologist will be able to give you additional answers. I will just say again that even hearing people don't always hear perfectly, see my latest reply to you above(post #17)

We know you have a mild hearing loss in the speech range and a more severe hearing loss in the high frequencies. Let us know what your audiologist says about transpositional HAs and cochlear dead zones.

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ecp

So, I'm a huge science nerd...it is sort of my job...and I love reading about science and medicine.
I'm linking to a few websites that could help you learn more about hearing if you want to learn more.
Raising Deaf Kids
What Is An Audiogram? - My Baby's Hearing
How to Understand Your Hearing Test - Hearing Aid Resource for Consumers with sample audiograms Common-audiograms - Hearing Aid Resource for Consumers

All of these are aimed at "regular" (aka non Audiologists) people.

faire_jour

Actually, everyday her language gets better, so I don't think 86% is good for her. I think she will end up close to 100%. Right now she is still learning the language. There are words that she didn't know on the test, not that she wasn't able to discriminate, but just had never heard before. Remember, she has only had the implant for 9 months (at the time) and that she only has the language of a 4 year old (up from 18 months with hearing aids).

shel90

Agreed...my brother and I are a perfect example. We were both born with almost the exact same Db losses but I was able to decipher sounds and speech better than he could.

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Shel~

"A child educated only at school is an uneducated child." -George Santayana