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Unread 04-29-2006, 11:52 PM   #1
sr171soars
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Differences between HA and CI...

This thread will highlight the differences between HAs and CIs. This should be helpful for those not as familiar with CIs and it has been a prominent issue lately. More people are familiar with HAs but not as many are personally familiar with CIs.

My background/experience - I have had a HA for many years since 3 years old and worn them for four decades. About a year ago I recently obtained a CI and it was a tremendous success for me.

HA (Assumes a BTE model non digital)
1) Uses one battery - typically lasts one week (at least for me...YMMV)
2) Ampifies sounds to ear
3) Uses a mold for getting amplified sound to ear (get feedback, moisture issues though)
4) Uses natural hearing system
5) Not water resistance (maybe some recent models might provide this feature...I don't know)
6) No surgery required
7) Consists of BTE only
8) A HA can mask tinnitus but never cure it (one will hear it as soon as HA is either off or removed)
9) A HA will provide hearing that is closer to what hearing people hear (Make no mistake...a hearing loss presupposes some difference in either range of sound frequencies or distortion factors in hearing)
10) A HA is only as good as one's hearing at the time (meaning if you have some loss in certain ranges or distortions, a HA can't make up for that)
11) HAs have limited programmable functionality (particularly digitals - it is getting better but nowhere near what CIs can do)
12) People with similar losses can "borrow" another's HA to use (assuming one switches molds)
13) If deaf or nearly so, a HA has no benefit
14) If one decides not to use a HA anymore, they just take it off and put it away
15) There are no instant setting options available to change to the appropriate environment

CI (Cochlear Inc. Freedom)
1) Uses three batteries (P675 types but cochlear implant version - get three days worth because CI is a little computer and has serious power comsumption)
2) Stimulates cochlear nerve
3) No mold required
4) Bypasses outer and middle ear - Goes straight to inner ear...specifically the cochlea and cochlear nerve
5) Is water resistance but not waterproof (it can take sweat, light rain and other such water incidents)
6) Requires surgery for implant portion - nowadays this is an outpatient procedure usally takes less than 3 hours and one is home the same day
7) Consists of BTE and implant (A magnetic transmitter using a FM frequency transmits the electrical impulses from the BTE to the imbedded implant)
8) A CI can sometimes cure tinnitus but it is not a guarantee and never a reason to get a CI (It cured my mild tinnitus) If it doesn't cure it, it has same ability to mask it.
9) A CI at first will sound very different like the robotic or cartoon characters. Over time, it will sound normal as the brain is incredibly "plastic" in its ability to adapt to input. (I can recognize any sound as I heard before with my HA - Actually I'm getting more information and things like thunder are much richer than before)
10) A CI will give a consistent range of sounds (however it is only from almost the lowest possible to up about 11khz - normal hearing is the lowest to about 20khz - not really a problem as all speech is below 11khz and most sounds are as well)
11) CIs are very programmable and provide many possibilities as suitable for any given person (far more than current digitals)
12) Due to nature of specific unique programming of each CI, no one can "borrow" another's CI to use (there is a identification code on every Freedom CI tied to the implant of the individual - this does two things, save the individual from accidently damaging their cochlea when using the wrong CI but also keeps theft down as no one can use it but the individual it is programmed for)
13) To get a CI, one must get no benefit from a HA and being deaf is no barrier to using one
14) If one decides not to use a CI anymore, put the BTE portion away but the implant stays put unless it is surgically removed (not really necessary - mostly a personal preference)
15) The CI have an option to change to one of four programs in an instance as appropriate the environment (I just push a button on the BTE and it beeps the program corresponding to the number it is (i.e, 1 for program 1 which is my normal setting where as 4 is autosentivity for loud environments like traveling in a car with the windows down but still be able to hear the person talking to me)

Umm...I sure there are some others and if there are please kindly point them out.

On a personal note, I have noticed these differences...

I can now hear the higher ranges that I couldn't before (I had no idea that a water faucet can be so loud and higher pitched than I thought it was with my HA). I can depend on my hearing unlike before (somebody will start talking [and I'm paying attention to something else] and I pick it up right then and not to have to say "wait a minute" to get my attention on the person).. I never could do that with my HA except in unusal situations. I'm hearing at a much "louder" level close to what hearing people hear (if a person is speaking softly...it is not a problem for me whereas before I had to ask them to speak up). I can hear around corners and out of sight of person speaking and hear every word (really, really nice). I can hear in the dark whereas before I had to ask people to turn on the light to hear them (this is more useful than you can imagine). Keeping up with a person in a noisy environment isn't so challenging as it was before with a HA. I don't get exhausted from listening so intently putting all my energies into hearing (social settings are fun now for however long they may be). I can use any phone (don't need a special phone) anywhere including cell phones and doing conference calls.

Sorry for the long post but I hope some people find it helpful...
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Unread 04-30-2006, 12:17 AM   #2
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Thanks for the info. I think it will be very informative for people that visit.
Also coming from you, being an experienced user, is very important.

Also your personal experience is excellent info. I hope more people will contribute to it.

I hope the "HA's are the same as CI" argument will be history, or at least this topic will give posters to refer to it when the argument is used.

Thanks again
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Unread 04-30-2006, 12:46 AM   #3
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Quote:
Originally Posted by sr171soars
This thread will highlight the differences between HAs and CIs. This should be helpful for those not as familiar with CIs and it has been a prominent issue lately. More people are familiar with HAs but not as many are personally familiar with CIs.

My background/experience - I have had a HA for many years since 3 years old and worn them for four decades. About a year ago I recently obtained a CI and it was a tremendous success for me.

HA (Assumes a BTE model non digital)
1) Uses one battery - typically lasts one week (at least for me...YMMV)
2) Ampifies sounds to ear
3) Uses a mold for getting amplified sound to ear (get feedback, moisture issues though)
4) Uses natural hearing system
5) Not water resistance (maybe some recent models might provide this feature...I don't know)
6) No surgery required
7) Consists of BTE only
8) A HA can mask tinnitus but never cure it (one will hear it as soon as HA is either off or removed)
9) A HA will provide hearing that is closer to what hearing people hear (Make no mistake...a hearing loss presupposes some difference in either range of sound frequencies or distortion factors in hearing)
10) A HA is only as good as one's hearing at the time (meaning if you have some loss in certain ranges or distortions, a HA can't make up for that)
11) HAs have limited programmable functionality (particularly digitals - it is getting better but nowhere near what CIs can do)
12) People with similar losses can "borrow" another's HA to use (assuming one switches molds)
13) If deaf or nearly so, a HA has no benefit
14) If one decides not to use a HA anymore, they just take it off and put it away
15) There are no instant setting options available to change to the appropriate environment

CI (Cochlear Inc. Freedom)
1) Uses three batteries (P675 types but cochlear implant version - get three days worth because CI is a little computer and has serious power comsumption)
2) Stimulates cochlear nerve
3) No mold required
4) Bypasses outer and middle ear - Goes straight to inner ear...specifically the cochlea and cochlear nerve
5) Is water resistance but not waterproof (it can take sweat, light rain and other such water incidents)
6) Requires surgery for implant portion - nowadays this is an outpatient procedure usally takes less than 3 hours and one is home the same day
7) Consists of BTE and implant (A magnetic transmitter using a FM frequency transmits the electrical impulses from the BTE to the imbedded implant)
8) A CI can sometimes cure tinnitus but it is not a guarantee and never a reason to get a CI (It cured my mild tinnitus) If it doesn't cure it, it has same ability to mask it.
9) A CI at first will sound very different like the robotic or cartoon characters. Over time, it will sound normal as the brain is incredibly "plastic" in its ability to adapt to input. (I can recognize any sound as I heard before with my HA - Actually I'm getting more information and things like thunder are much richer than before)
10) A CI will give a consistent range of sounds (however it is only from almost the lowest possible to up about 11khz - normal hearing is the lowest to about 20khz - not really a problem as all speech is below 11khz and most sounds are as well)
11) CIs are very programmable and provide many possibilities as suitable for any given person (far more than current digitals)
12) Due to nature of specific unique programming of each CI, no one can "borrow" another's CI to use (there is a identification code on every Freedom CI tied to the implant of the individual - this does two things, save the individual from accidently damaging their cochlea when using the wrong CI but also keeps theft down as no one can use it but the individual it is programmed for)
13) To get a CI, one must get no benefit from a HA and being deaf is no barrier to using one
14) If one decides not to use a CI anymore, put the BTE portion away but the implant stays put unless it is surgically removed (not really necessary - mostly a personal preference)
15) The CI have an option to change to one of four programs in an instance as appropriate the environment (I just push a button on the BTE and it beeps the program corresponding to the number it is (i.e, 1 for program 1 which is my normal setting where as 4 is autosentivity for loud environments like traveling in a car with the windows down but still be able to hear the person talking to me)

Umm...I sure there are some others and if there are please kindly point them out.

On a personal note, I have noticed these differences...

I can now hear the higher ranges that I couldn't before (I had no idea that a water faucet can be so loud and higher pitched than I thought it was with my HA). I can depend on my hearing unlike before (somebody will start talking [and I'm paying attention to something else] and I pick it up right then and not to have to say "wait a minute" to get my attention on the person).. I never could do that with my HA except in unusal situations. I'm hearing at a much "louder" level close to what hearing people hear (if a person is speaking softly...it is not a problem for me whereas before I had to ask them to speak up). I can hear around corners and out of sight of person speaking and hear every word (really, really nice). I can hear in the dark whereas before I had to ask people to turn on the light to hear them (this is more useful than you can imagine). Keeping up with a person in a noisy environment isn't so challenging as it was before with a HA. I don't get exhausted from listening so intently putting all my energies into hearing (social settings are fun now for however long they may be). I can use any phone (don't need a special phone) anywhere including cell phones and doing conference calls.

Sorry for the long post but I hope some people find it helpful...
Some people have problem with HA and some others are not, just depends on their hearing condition or so. HA is work on mine since profound deaf.
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Unread 04-30-2006, 12:46 AM   #4
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in my case, AB HiRes Auria (HiRes = Hi Resolution)

1) use rechargeable battery in two size form slim - avg 10hrs max plus - avg 20hrs max

2) cochlear nerve = auditory nerve
3) ditto
4) ditto cochlear nerve = auditory nerve
5) ditto
6) ditto hrs varies can be home same day or overnight as per dr's discretion
7) ditto actually it is RF (Radio Frequency, not FM or your CI system would be interfered by FM system in certain building
8) ditto
9) ditto
10) the speech sounds are between 250hz and 4000hz from 20 to 50 dB
(just for you, sr171soars, you may want to read this: http://www.wired.com/wired/archive/13.11/bolero.html on page 2 especially )
11) ditto
12) actually CI can be loaned but have to be remapped temporarily though
13) ditto
14) actually "stop using speech processor" so meaning either BTE or BWP
15) AB has 3 slots and BWP has 3 but 4 for kids.
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Unread 04-30-2006, 01:14 AM   #5
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Quote:
Originally Posted by sr171soars
...
...12) Due to nature of specific unique programming of each CI, no one can "borrow" another's CI to use (there is a identification code on every Freedom CI tied to the implant of the individual - this does two things, save the individual from accidently damaging their cochlea when using the wrong CI but also keeps theft down as no one can use it but the individual it is programmed for)
...
That's correct, but like Boult stated, one can loan them.
We had that lately where 1 of the CI's of my daughter broke. Instead of not using it for 2 weeks, we have the possibility to get a "loan" which the provider will program with the MAP from the latest mapping session.
So you can't just exchange them, it does require professional handling.
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Last edited by Cloggy; 04-30-2006 at 01:14 AM. Reason: Spelling
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Unread 04-30-2006, 02:05 AM   #6
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Thanks for posting this. I think it's important for some people to know because there are people like me who can't benefit from hearing aids anymore and CIs is a viable option, simply because it works in a different way.
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Unread 04-30-2006, 01:23 PM   #7
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Quote:
Originally Posted by Boult
...
7) ditto actually it is RF (Radio Frequency, not FM or your CI system would be interfered by FM system in certain building
...
10) the speech sounds are between 250hz and 4000hz from 20 to 50 dB
(just for you, sr171soars, you may want to read this: http://www.wired.com/wired/archive/13.11/bolero.html on page 2 especially )
Well, I was told it was FM but not in the range of the radio frequencies so I couldn't pick them up anyway...wouldn't be a bad idea if I could

Read the link...nice article. Thanks for pointing it out. I agree with you on the speech range but I read somewhere that one could hear (with Freedom) as high as 11khz but that was it. I'll try to find the info.
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Unread 04-30-2006, 03:15 PM   #8
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That article IS great. You should also read his book "Rebuilt: How becoming part computer made me more human" its fantastic.
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Unread 04-30-2006, 03:32 PM   #9
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That article IS great. You should also read his book "Rebuilt: How becoming part computer made me more human" its fantastic.
I was going to comment with this book title! I just finished reading it, and was astounded by the amount of information Michael Chorost managed to pack into 200 pages. Great book.
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Unread 04-30-2006, 06:25 PM   #10
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Quote:
Originally Posted by ayala920
I was going to comment with this book title! I just finished reading it, and was astounded by the amount of information Michael Chorost managed to pack into 200 pages. Great book.
Yeah, I don't know if you have visited his website; http://www.michaelchorost.com/ he's a writer though...
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I find that when I'm channel surfing, Fox News is like that carton of milk way past its expiration date, taunting you from the back of the refrigerator. You KNOW it's gonna smell, but still you open it up and take a whiff. by: bc68251 on February 21, 2006
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Unread 04-30-2006, 07:25 PM   #11
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Quote:
Originally Posted by Boult
Yeah, I don't know if you have visited his website; http://www.michaelchorost.com/ he's a writer though...
Yes Michael Chorost is a very good writer. I really enjoyed his book, and his comparisons to hearing and deafness were really cool. That's why I use one of his quotes in my sig file
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Unread 04-30-2006, 08:20 PM   #12
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I do know that there are the differences between hearing aids and cochlear implants. While some might not benefit with cochlear implants or hearing aids, Looks like they're stuck with nothing. While there are some others who benefit with cochlear implants not with hearing aids, and there some can benefits with hearing aids don't need to get cochlear implants. Which means identifying differences between sounds, describing how pitch or loudness changes, and repeating back words and sentences, can hear phone and etc. (Most of those people are hard of hearing) I know two members of AD, that I've met in person can hear better with their hearing aids, Which Roadrunner and Vampy. I remember calling out his name and he turned around. It's like wow he can really hear with hearing aids, Same with Roadrunner too.
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Unread 04-30-2006, 08:35 PM   #13
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It all boils down to how much residual hearing is available to be worked with. Many deaf are able to do very well with hearing aids because they have enough residual hearing to benefit from them. Those with little or no residual hearing, who get no benefit from a hearing aid will most likely get some with a CI.
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Unread 04-30-2006, 09:36 PM   #14
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Quote:
Originally Posted by neecy
who get no benefit from a hearing aid will most likely get some with a CI.
Not everybody, It depends on the individuals.
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Unread 04-30-2006, 10:59 PM   #15
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Correction, the amount of resdiaul hearing can vary from awareness of enviromental sounds to being functional hoh and every and anything in between! It's probaly very rare that NO response to sound is gotten.
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Unread 05-03-2006, 06:56 AM   #16
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Update on CI info...

I just had a nice talk with my Audi (I was getting my second processor finally - it took forever to come in due to the color I chose [Blue]). Anyway, she got me straight and stated that the highest I could possibly hear at this point was about 7khz not the 11khz as I originally thought. She did point out that the 20khz threshold (the high end) is always a moving target as a newborn to toddler will probably hear that easily but it goes downward as one ages. That is probably very indicative of our noisy society.
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Unread 05-03-2006, 07:19 AM   #17
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15) There are no instant setting options available to change to the appropriate environment

Do you mean multiple programs, and possibly automatic switching? Because I know I've had aids that have done that. My previous set of aids (Phonak) had 3 programs, and I'm told the generation after that (same line, new model) switched automatically. My current aids don't exactly switch programs, but they do dynamic noise filtering, so they do adapt the the environment. And some of the current Oticons (not sure about other brands) have multiple programs - I think you can have them switch automatically or set it to manual only, as you wish.
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Unread 05-03-2006, 09:28 AM   #18
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Quote:
Originally Posted by ismi
15) There are no instant setting options available to change to the appropriate environment

Do you mean multiple programs, and possibly automatic switching? Because I know I've had aids that have done that. My previous set of aids (Phonak) had 3 programs, and I'm told the generation after that (same line, new model) switched automatically. My current aids don't exactly switch programs, but they do dynamic noise filtering, so they do adapt the the environment. And some of the current Oticons (not sure about other brands) have multiple programs - I think you can have them switch automatically or set it to manual only, as you wish.
Thanks for bringing that point up.

One question though, are these HAs you speak of digitals? Please excuse my ignorance as I only had analogs and now I obviously have a CI.
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Unread 05-03-2006, 12:14 PM   #19
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Quote:
Originally Posted by sr171soars
Thanks for bringing that point up.

One question though, are these HAs you speak of digitals? Please excuse my ignorance as I only had analogs and now I obviously have a CI.
apparently so...
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I find that when I'm channel surfing, Fox News is like that carton of milk way past its expiration date, taunting you from the back of the refrigerator. You KNOW it's gonna smell, but still you open it up and take a whiff. by: bc68251 on February 21, 2006
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Unread 05-03-2006, 02:26 PM   #20
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Quote:
Originally Posted by sr171soars
Thanks for bringing that point up.

One question though, are these HAs you speak of digitals? Please excuse my ignorance as I only had analogs and now I obviously have a CI.
My current aids are, as are the new Oticons I mentioned (I was thinking specifically of the Sumos and the Adaptos, but I think some, if not all, of their others are as well). The previous generation I mentioned were called ... wait for it ... programmables. Unfortunately, that particular model was controlled by a remote control for some idiotic reason (my audiologist speculated that the target market was geriatrics, for whom dexterity might be an issue).

Current "digital" aids, the set I'm wearing now (or would be, if not for the fact that I'm waiting for a mastoidectomy) have multiple modes. They can be set to digital, analog, or a sort of happy medium. From watching my audiologist program it, and from what she tells me, the major distinction is that this mixed-mode gives more granularity (so there are more frequency bands that can be tweaked based on audiogram and personal preference), but not quite as much as the digital. The other major distinction, as I understand it, is that the digital mode tends to do more autonomous stuff (switching programs, squelching noise, compression) while the mixed mode acts more like an old analog aid (less switching of programs, less noise filtering, less compression).

Most of her patients are young; she says that the younger patients tend to prefer the pure digital mode while older patients tend to prefer the mixed and analog modes. Whether this is actually due to age and adaptability to changing settings, the "In my day ..." phenomenon, or the tendency of the brain to mold to what it knows (sort of the same idea as with implanting CIs early) she doesn't know.

I don't know for sure, not being all that familiar with CIs, but I suspect that the level of programmability and automated-ness is pretty much the same as with a digital BTE. Probably more so with a bodyworn CI, given that you have more room to play with, but otherwise I'd guess it's largely the same. The confusion, if that's the case, could be due to the fact that you're switching to a more modern technology that you haven't used before (and would be doing so even with HAs) or could be due to the fact that sometimes the more modern technologies aren't available in the most powerful aids (so, pre-CI, the aids available to you were less bleeding-edge). Again, I'm just SWAGing here - it's just a guess.
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Unread 05-03-2006, 02:45 PM   #21
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Quote:
Originally Posted by ismi
...
I don't know for sure, not being all that familiar with CIs, but I suspect that the level of programmability and automated-ness is pretty much the same as with a digital BTE. Probably more so with a bodyworn CI, given that you have more room to play with, but otherwise I'd guess it's largely the same. The confusion, if that's the case, could be due to the fact that you're switching to a more modern technology that you haven't used before (and would be doing so even with HAs) or could be due to the fact that sometimes the more modern technologies aren't available in the most powerful aids (so, pre-CI, the aids available to you were less bleeding-edge). Again, I'm just SWAGing here - it's just a guess.
To give a little background, I was in the market for a digital as my analog was some ten years old (Fall of 2004) and still ticking strong. My hearing just wasn't getting enough from it and therefore the looksee at digitals. When I was told that I was legally deaf and dropping rapidly, they pointed me to the direction of a CI. The rest as they say is history and I got my CI in Spring of 2005. You are right, I basically jumped a generation (or two) into a CI. That explains my lack of familiarity with digitals although I heard about programmability and digitals were the "thing" and so on. When it is sort of working for you and you don't want to think about spending a wad of bills for a new one...you tend to not look too closely.
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Unread 05-03-2006, 03:32 PM   #22
ismi
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Quote:
Originally Posted by sr171soars
When it is sort of working for you and you don't want to think about spending a wad of bills for a new one...you tend to not look too closely.
I hear you - that's sort of where I am now, in the sense that I think a new aid might be beneficial, but I don't want to even touch the idea of paying for a new one. To exacerbate that conflict, my audiologist likes it when I try new models since I'm old enough to know what I like (as I said above, most of her patients are pretty young). And the engineer in me just can't resist ... "ooh, this one works with the bluetooth boot? And you say it has an auto-whatsit?"
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Unread 05-18-2006, 10:59 AM   #23
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Difference in Graph

Browsing through all the stuff I collected while getting info regarding CI I found this one... (looking for something else - but what the heck...)


Speaks for itself

It's coming from THIS article... (2004)
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Unread 05-18-2006, 12:59 PM   #24
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Wow Cloggy I am suprised how close your daughter's CI hearing is to normal hearing range! and in one instance even above!
I guess that is pretty impressive. one thing we probably will never know - how true to normal hearing sound-wise is hearing thru CI in this range..

Fuzzy
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Unread 05-18-2006, 02:07 PM   #25
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Quote:
Originally Posted by Audiofuzzy
Wow Cloggy I am suprised how close your daughter's CI hearing is to normal hearing range! and in one instance even above!
I guess that is pretty impressive. one thing we probably will never know - how true to normal hearing sound-wise is hearing thru CI in this range..

Fuzzy
No, not my daughters.
I gave the link to the article with it.

Just wante to show graphically the difference between HA and CI.
(Of course, hearing is still not understanding.)
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Unread 05-18-2006, 03:06 PM   #26
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Oh sorry I missed the link. Still, even if it is not your daughter what I wrote apply to whoever is there implanted...

(can't open the link -it's PDF Adobe, takes too long - maybe I'll ry again later)

Fuzzy
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Unread 05-18-2006, 03:13 PM   #27
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Cloggy,

Is that bold line for the level of average hearing range of 35 HLiD?

Thanks..
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Unread 05-18-2006, 03:23 PM   #28
Liebling:-)))
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Well, my friend is deaf and speak like HOH and wear HA since she was 6 months old.

Her parents wore HA on her when she was 6 months old. Her parents spent their times to communciate with her... Now she CAN phone to her family with HA and speak like HOH. I suggested her to consider CI but she said that she is happy with HA.
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Unread 05-18-2006, 03:46 PM   #29
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Quote:
Originally Posted by Mookie
Cloggy,

Is that bold line for the level of average hearing range of 35 HLiD?

Thanks..
Not sure about "HLiD" but the greyed area is where speech is "coming from".

Stupid me "Hearing Levels in Decibels"
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Unread 05-19-2006, 01:30 AM   #30
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Quote:
Originally Posted by Audiofuzzy
Wow Cloggy I am suprised how close your daughter's CI hearing is to normal hearing range! and in one instance even above!
I guess that is pretty impressive. one thing we probably will never know - how true to normal hearing sound-wise is hearing thru CI in this range..

Fuzzy
my audiogram shows mine in 20-30 in all range. so I am in the area that I could hear the ling sounds:
http://www.hardofhearingchildren.com...sound_test.htm

http://www.bionicear.com/printables/TFS-Ling-Spond.pdf
or
http://www.bionicear-europe.com/cgi/...dnow.cfm?id=73 (PDF)


the normal hearing level is from 0 to 20 dB
http://www.earinfo.com/howread1.html
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