10 Lessons My Hearing Ear Dog Taught Me.


As you may know, dear reader, my Hearing Ear Dog “Amie” has been living with cancer in her bladder (invasive transitional cell carcinoma) for some time now.  In fact, it has been almost 20 months ago that we were given the news that she may only have 2 months to live.  Somehow, she has beaten the odds and has survived much longer than expected.  All the vet can tell us is “Keep doing what you are doing.  I am not sure what it is is, but it seems to be working!”  To be honest, I am not sure either.

My wife and I were reflecting on the impact Amie has had on our lives.  In addition, how how Amie has changed my personality.

Here are some of the lessons Amie has taught me:

  1. Praise is Better than Punishment for Changing Behavior.  Amie never responded well to being punished.  She hated it and would shut down even if I simply raised my voice a bit. But boy did she love praise.  Works much better for humans too.
  2. Don’t Yell!  I was raised in an Eastern European household in which there was quite a bit of yelling.  We were all used to it and thought it was acceptable to fly off the handle once in a while.  Well, Amie never liked that, nor did my English wife.  However, whenever I had what our family referred to as a UTT (Ukrainian Temper Tantrum), Amie would hide in a corner and shake.  Within just a few short weeks of getting Amie, my UTT’s dropped off dramatically.  And they have stayed low for the 12+  years that Amie has been in our household.
  3. Virtue of a Simple Life.  We can get all hung up on the latest toys and gadgets in life.  Oh look, the Joneses next door now have an Acura and a Beemer.  But Amie had no use for any of those things.  Her favorite toy is a squeaky hedgehog and a tennis ball.  Her favorite activity was a walk in the woods.  She kept us grounded and humbled.
  4. Fortitude or Keep your Chin Up Despite Adversity.  Despite having herniated a disk in her spine, having cancer, and Idiopathic Vestibular Disease, Amie keeps wagging her tail, and loves our company. Similarly, being deafened may suck, but it clearly is not the end of the world.
  5. Forgiveness.  If I forgot to feed Amie, or didn’t take her for much of a walk, she always forgave me unconditionally.  So if, for example, someone forgets to speak clearly for me, I try to forgive.
  6. Identification of Good Character.  Amie is so sweet, she loves everybody.  There was no one that she hated, she saw good in everyone.  Some even overcame their life long fears of dogs after meeting Amie! But still, some folks did not like her.  And you know what, these people ended up not being nice people at all.  So having Amie saved me time but not wasting energy on these people.  On the other hand, there were folks I thought were unsavory characters, but because they took a positive interest in Amie, I also gave them a chance.  Turns out they were ok after all.
  7. Naps are a Good Thing.  Amie was always ready to alert me at any time, 24 hours a day.  How did she do it?  By being well rested!  We should all take more naps or at least get a good night’s sleep.
  8. Live Life to the Fullest.  A dog’s lifespan is much shorter than ours.  And there is nothing anyone can do about it.  Amie is 14.5 years old now, which is a pretty good life span for a dog.  But like all of our lives, it will end.  The Existentialists tell us that we could all use a healthy dose of Death Awareness to give us that kick in the butt we all need to get on with Living.  Nothing like seeing another creature’s life come to its end stages to reinforce that point.
  9. Adapt.  After Amie’s back surgery for her herniated disk in her spine, one of her back legs did not have the same strength.  But she quickly learned to get up and down stairs by lifting up this weaker leg.  For larger flights of stairs, we carried her up, but she didn’t complain.  So if we need to communicate differently due to our deafness. so what?  Wear the damn hearing aid, use the FM system, stop complaining and get on with participating in life.
  10. Be Sure to Say “I Love You”.  Ok, Amie can’t speak, but she can sure communicate her thoughts.  She always ran up to my wife, son, or myself with her tail wagging and gave us kisses.  Every single day!  You never get bored of being reminded that you are loved.

What’s in a Name? Terms for Hearing Loss


Various terminology is used to describe people with disabilities.  Interestingly, the terms we must use has become a sensitive issue.  Some terms are understandably negative.  For example, the terms idiot, moron, and imbecile used to be accepted terms to describe persons with varying degrees of intellectual disabilities. They are very hurtful terms and of course are not used anymore.  The etymology of the term handicap is believed to be related to begging for money, although this has been disputed by others.  Nonetheless, we must avoid this term as it now has negative connotations.  Strange that Joe in Family Guy uses this term to describe himself, but then again, Family Guy is not a place to learn political correctness.

Similarly, we use many terms or names to describe hearing loss.  Some of the commonly used ones include:

  • Hearing loss
  • Deaf-mute
  • Deaf and dumb
  • Hard of Hearing
  • Deaf
  • deaf
  • Hearing impaired
  • Deafened

Hearing loss is a nice generic umbrella term.  It encompasses conductive, sensorineural, or mixed losses.  I failed to find any reference on the internet to this term being negative or derogatory.

“Deaf-mute” and “Deaf and Dumb” both describe the notion that people with significant hearing loss from birth both cannot hear and cannot speak.  These terms should never be used as they are both inaccurate and of course derogatory.  Most kids born with hearing loss, when provided with appropriate auditory-verbal therapy, support and equipment do learn to speak extremely well and go on to achieve high levels of education.  Some families choose sign language for their children, and also can achieve great things.

“Deaf” and “deaf” are actually considered to be somewhat different terms.  Deaf, when used with a capital “D” (also know as “Big D Deaf”), typically describes members of the Deaf Community who use sign language as their method of communication.  The Deaf Community have their own cultural identity, social groups, drama productions etc.  When used with a lower case “d”, the term deaf or deafness is a general term to describe all degrees of hearing loss.  Typically, the image the term “deaf” conjures up is a person who uses sign language, and therefore, the term deaf, whether capitalized or not, version more commonly used to describe people who sign and cannot hear.

Deafened is also a term you see out there, and is one of the terms I use to describe my condition.  Typically it describes someone who has lost the majority of their hearing post-lingually (after the acquisition of spoken language).  However, deafened people may have had their hearing assisted via high powered hearing aids or cochlear implants.  There are organizations such as the Association of Late Deafened Adults in the US. So this term is well accepted.

Hearing impaired or hearing impairment seems innocent enough.  It can be used to describe a condition in which ability to detect certain or all pitches is either partially or completely impaired/

Interestingly, the terms “Hearing impaired” or “Hearing impairment” seem to be the ones that draw the most criticism and controversy today.  I was looking at the National Association of the Deaf website for their perspective on this term.  Here’s the first sentence “Deaf and hard of hearing people have the right to choose what they wish to be called, either as a group or on an individual basis”.  I completely agree with this statement.  Nobody should force a term on any group.  But here is the second statement “Overwhelmingly, deaf and hard of hearing people prefer to be called “deaf” or “hard of hearing.”  Really?  I completely understand and respect the wishes of the Deaf Community to NOT be called hearing impaired.  But I cannot recall anyone asking people with hearing loss who do not sign if they all wanted to be called Hard of Hearing.  When did this happen?

Hard of Hearing officially refers to those persons with hearing loss which is permits the use of the auditory channel for a certain amount of speech/language.  Hard of hearing people typically use hearing aids, cochlear implants, and FM systems.

I do not like the term Hard of Hearing.  In fact, I vehemently detest it. The problem I have with the term “Hard of Hearing” is two-fold. First is the image it conjures up.  And secondly, the proponents of this term to obtain failed to achieve consensus amongst people with hearing loss that this is the correct term that shall be used.

When I think of the term Hard of Hearing, I imagine a old person from the 1930’s with a listening tube stuck in the ear muttering “What’s that sonny?  I am Hard of Hearin’ and ya gotta shout!”.  I find the term archaic, unintelligent, and unflattering.

Hard of Hearing Person

I have asked many people who are not Big D Deaf (that is, the so called “Hard of Hearing”) about their feelings of these words.  Many do not object to either Hearing Impaired or Hard of Hearing.  It is becoming abundantly clear to me that it was the Deaf Community who did not like the term Hearing Impaired.  Again, that is fine.  I completely respect this.  But what I object to is that the term Hard of Hearing was forced upon everyone else.  We could have gone with Deaf and Hearing Impaired rather than Deaf and Hard of Hearing.  Don’t get me wrong, I am not necessarily seeking to resurrect the term “hearing impaired”.  If that term is dead, so be it.  But I will do everything I can to also kill off the term Hard of Hearing, I hate it that much.

I am very glad that in the US, the group “Self Help for Hard of Hearing” (SHHH) changed their name to the Hearing Loss Association of America (HLAA).  This new name has no negative connotations, and is generic enough to encompass all people with hearing loss.  It is a very welcoming term.  I have joined the HLAA, but not our own Canadian Hard of Hearing Association (CHHA), entirely due to the name.

In the end, the most important thing that all of us people with hearing loss desire is to be seen as people first.  Yes I have a hearing loss and use a cochlear implant, hearing aid, and FM system.  But I also am a father and husband.  I have a graduate degree in Audiology.  I love music, and play bass in a band.  I love to kayak, fish, and hunt.  I am all these things, and I do not wish to be defined solely by one attribute.  So perhaps the term People with Hearing Loss may be the best term of all, as it emphasizes the person first.

What Does a Cochlear Implant Sound Like?


It has been almost 7 years since I received my Cochlear Implant.  However, it seems just like yesterday.  I can still remember every detail from the time of surgery, to my first activation, and all the steps along the way to the restoration of my hearing.

I was not always deaf.  I was born with normal hearing.  I did not have meningitis, nor do I have any family history of hearing loss.  The only thing notable thing in my clinical history was that I had a series of painful ear infections.  It is likely one of those infections that caused the damage to my inner ear.

I began using hearing aids at the age of 5.  Over time, my hearing continued to worsen.  By the time I was in high school, my hearing loss was moderate-severe.  In University, my loss was in the severe range.  Interestingly, I did not begin using an FM system until my third year of University.  I simply did not know such devices even existed. I wish I was made aware of FM systems earlier, as I suffered academically from not hearing well.  In high school with smaller class sizes, I was an Honour Role student.  But in first year University, my average dropped to 60% and my initial hopes for studying Medicine were dashed.

I vowed to ensure that all people with hearing loss become fully informed of all the hearing devices or other forms of help that are available.  I did not want to see others struggle needlessly from hearing loss.  Thus, I decided to pursue studying Audiology and make this my personal mission.

But back to my original story about my CI.  Even though my loss was now in the severe range, hearing aids and FM systems provided me with considerable assistance.  My word identification scores were still in the 70% range.  However, as I crossed the line into a profound loss of hearing, my ability to understand speech started to diminish considerably.  By the time I became a candidate for a Cochlear Implant, my word identification scores were 0% for my right ear and 10% for my left ear.  Phone use was virtually impossible.  I struggled to lipread every word.  It was exhausting to try to carry on a  conversation.

I received my Cochlear Implant from the excellent surgery and audiology team at Sunnybrook Hospital in Toronto.  The surgery process went without a hitch.  I was out of the hospital the next day, and took a only a few days off from work.

After a month of healing, I went for my initial programming session.  I thought that I would be well prepared for this appointment.  After all, I am a trained Audiologist.  I have counseled patients myself about not having unrealistic expectations, especially on the first day.  But I knew there were some patients who could hear speech even on the first day of activation.  I wanted to be one of those people.  I felt I was entitled to be one of those people.  I was wrong.

After the initial Mapping was done, I listened to speech for this first time.  And it sounded like…GARBAGE.  Specifically, it sounded like R2D2.  It was just all a bunch of beeps and chirps.  I drove home that day and decided a nice bottle of single malt Scotch was needed.  I was feeling every emotion from anger, to bewilderment, to sadness.

But to make a long story short, the changes that occur over the next 6 months were rapid.  After about 2 weeks, the implant started sounding like Sammy the Snake hissing sentences into my head.  That’s better than R2D2.  Then it changed to Alvin from the Chipmunks.  Next it started to sound like a young Jerry Lewis.  Now it sounds pretty normal, at least to me.

My word identification score started to rapidly improve.  I cannot recall all of my scores, but after about 6 months I was understanding about 70% of monosyllabic words in isolation and 100% of words in sentences.  After one year, my monosyllabic word identification score for words in quiet improved to 96%.  I was and continue to be completely blown away by this.  After all, I started hearing just beeps and chirps.

Given that I recall having much better hearing, I can describe the difference between hearing through a CI vs a hearing aid.  Basically, when I had enough hearing to benefit from a hearing aid, speech and music sounded full and rich.  But as my hearing loss progressed, all I heard from the hearing aid were low pitches.  Everyone sounded like they had mashed potatoes in their mouths.

The CI sounds very crisp and precise.  I hear all the high frequency fricatives (s, sh, f, th etc) quite well.  I have been told that my speech has improved immensely, although I never realized that my speech production was deteriorating with my progressive hearing loss.  In hindsight, it makes sense.

Music and hearing in noise remained problematic.  To help with hearing in noise, we can get the same improvements hearing aid users get from the use of Directional Microphones or FM systems.  I use both with my CI and it helps.

For me personally, the use of a hearing aid in my non-implanted ear has helped with music perception.  Without a hearing aid, I can barely hear any bass at all. Bass makes music sound full and rich.  On the other hand, the treble I get from the CI makes speech and music sound clear and crisp.  Thus the CI on its own is fine for speech, but makes music sound like it is coming out of a small radio rather than a big stereo.  The hearing aid on its own sounds pretty bad for any type of sound, speech or music.  Combined with the CI, it does not help with speech, but does give music a richer deeper sound.

For those of you considering a Cochlear Implant, my single best word of advice to you is be patient.  Do not expect miracles, especially on the first day.  The improvements will come as your brain relearns to makes sense of these electrical signals.

Please remember too, that everyone is unique.  While my experiences are not uncommon, your pace of improvements and the final levels you reach could be better or worse than me.

I am so glad I took the step of getting a Cochlear Implant and would do it all over again in a heartbeat.

Best and Worst Musical Instruments for People with Hearing Loss


As a hearing impaired audiologist, and amateur musician, I often get asked by parents to help select a musical instrument for their child with hearing loss.  Although I have not seen a specific research study analyzing this exact question, we can, based on what we know about hearing loss, make an educated recommendation.

Lets first take a look at some fundamental components of music.  These include Pitch, Timbre, Harmonics, Loudness, and Rhythm.

Pitch is the frequency of the sound, measured in Hz.  For example, middle C is 256 Hz.  When we hear a melody we hear changes in pitch. In Western music, the smallest unit of pitch change is the semi-tone and there are 12 semitones in one Western octave.

Unfortunately, people with hearing loss have reduced ability to recognize pitch due to the damage in the hair cells of the cochlea.  In other words, some people with hearing loss cannot tell the difference between two pitches that are close together.  They need larger and larger differences between two pitches before they can tell that they are different.

Harmonics are a series of tones that are multiples of the fundamental frequency.  So if I pluck a middle C on a guitar or a piano, you will not only hear the fundamental frequency of 256 Hz, but also mathematical multiples of the middle C such as 512 Hz.  Again, this is a pitch based perception task and is hard for people with hearing loss.

Timbre is the unique combination the pitch, harmonics, the attack and release times of the note, that gives each musical instrument its unique colour and character.  Timbre is what tells us a guitar is a guitar or a violin is a violin.  This can also be hard for people with hearing loss.

Intensity of sound is measured in decibels.  We perceive intensity as “loudness”.  Of course when we have a hearing loss, soft sounds are inaudible, but hearing aids and cochlear implants do a pretty good job of allowing us to hear the soft sounds again.

Finally rhythm is the arrangement of sounds in time.  It is the beat or pulse of the music, and fortunately, people with hearing loss can still perceive rhythm quite well.

So based on what we know about hearing loss and about the components of music, it is clear that we will have greater difficulty with instruments that require good pitch perception abilities.  Below are two suggested list of instruments.  The first is a list of good instruments to select for people with hearing loss.  The second is a list of instruments that may be too challenging for the hearing impaired ear.  These lists are based on theory and some practical personal experiences, but are only recommendations.  If you, or your hearing impaired child, have your heart set on playing a particular instrument, by all means give it a try.

  1. Piano.  Piano is a good instrument for people with hearing loss for many reasons.  First, it is professionally tuned, so you do not need to tune it up every time you play.  If it is out of tune, then then the other instruments playing with the piano, must be tuned to the piano, and not the other way around.  Moreover, it is kind of like typing.  You see a symbol on the music staff, and you have to hit the corresponding key of the keyboard.  The hard part about piano is the same for all people, whether they have a hearing loss to not, which is learning to read multiple note music.
  2. Acoustic or Classical Guitar.  Guitar has frets on it, which precisely cuts the string at the correct point to give the correct note.  Daily tuning is required, but the easy solution here is to buy an electronic tuner.  I also think acoustic guitar is easier on the impaired ear than electric guitar.
  3. Fretted Electric Bass Guitar.  The fretted electric bass also has frets that precisely cut the string at the correct point.  Interestedly, this is why Leo Fender, the inventor of  the first electric bass, called it the  “Precision” or “P-Bass”.  It was the first bass with frets.  With bass, one only plays one note at a time, making this easier on the ears to perceive.  Also, it is also a rhythm based instrument which should be easier for people with hearing loss.  (Although some people just have no rhythm period).
  4. Electric Guitar.  I ranked electric guitar lower than acoustic guitar because when used with a lot of distortion, it is hard to hear the notes through all those harmonics.  If you plan to play electric guitar, stick with genres like indy or popular music, and stay away from heavy metal, or hard-core.  However, a plus of electric guitar is that you can get an amp with a headphone jack and plug your FM system into that for practicing.
  5. Digital Drums.  One of the problems with drums is that they can get really loud and overload the microphones of the hearing aids and cochlear implants.  So this is what is nice about a digital drum kit.  You get a volume control that allows you to set the volume at a perfect level, not too loud or too soft.  Moreover, all the digital drum kits I have seen have headphone jacks to plug your FM system in.
  6. Flute.  General the woodwind instruments can be good choices because there are lots of keys that allow you to make the correct note more precisely.
  7. Clarinet. Same as flute
  8. Saxophone.  Same

Challenging Instruments to Play with Hearing Loss.

  1. Violin.  Violin does not have any frets on it.  It requires one to listen carefully to make sure you are pressing on the correct part of the fingerboard.   However, I have heard of people with hearing loss still successfully playing this instrument.  It all depends on your hearing capabilities.
  2. Viola.  Again, same as a violin
  3. Cello.  Same issue as violin.
  4. Upright or Fretless Bass.  Same as violin
  5. Trombone.  Trombone shares some of the same characteristics of a fretless string instrument.  One must move the slide to the correct point to produce the proper pitch and therefore requires good pitch perception.  Not easy on the ears.
  6. Acoustic Drums.  The reason I put acoustic drums on the “Challenging” list is that this is a very loud instrument.  Very loud sounds can over-saturate the microphone or the analog/digital converter in a hearing aid or cochlear implant.  This will make things sound really distorted.  Interestingly, when I play in my band, I actually try to move as far away from the drums as possible.  I still keep the beat using the device I made.  See this previous posting.
  7. Trumpet. Trumpet uses a combination of three buttons or valves to partially produce its pitch.  The other influence is the shape of the lips.  Therefore, it does require a bit of hearing pitch perception to make the correct note.  I successfully played trumpet when I was in high school, but I only had a moderate loss of hearing at that time.
  8. French Horn.  Similar issues to a trumpet.  However, I found that the shape of the lips affected the pitch more in a French Horn than trumpet.  Not sure why, but the French Horn players in our high school band had a harder time keeping pitch than the trumpet section.

So there you have it.  If you are currently playing an instrument and you have a hearing loss, please share your experiences!