This short but interesting blog post and link to a BBC article is excellent reading. Enjoy! And thanks to Vidya Krull for this post.
As you all know, I love music. I wish I loved visual art or sports more, but I don’t. I love music and with my verkakte ears, its not an easy task. I decided to review the literature and see what the research tells us about music perception in cochlear implants (CI’s).
If you look at some of the earlier research prior to 2000, you barely see much reference to music perception in CI’s. I think the researchers, and engineers were busy working on getting good speech perception. Makes sense. And as the speech perception abilities of CI users began to improve, interest began to shift to other important listening abilities such as musical perception.
One researcher who has done a lot of work in this area is Dr. Kate Gfeller. In a 2000 article (J Am Acad Audiol. 2000 Jul-Aug;11(7):390-406), Gfeller et al found that 83% of adult CI users reported diminished music enjoyment post-implantation. In fact one third of the CI users even avoided music altogether as they found it to be an aversive sound. These are not encouraging results. But do remember that these folks received their implants in the 1990’s. This technology is now 20 years old.
Looi et al, 2007 (Ear & Hearing: April 2007 – Volume 28 – Issue 2 – pp 59S-61S) did a study comparing the music perception of CI users compared to hearing aid (HA) users. Note that the HA users were all potential CI candidates, so they all had significant hearing loss. This study showed that while neither device (HA or CI) provided satisfactory music perception results, the CI users gave slightly better ratings than the HA users. So now we are actually seeing some data showing music perception getting better with a CI, but still not great.
Another study by Looi et al in 2008 (Ear & Hearing: June 2008 – Volume 29 – Issue 3 – pp 421-434) looked again at CI users and HA users who were potential CI candidates. So again these HA users also had significant hearing loss. On a rhythm recognition task, both groups did about the same. On the pitch perception task, the HA users outperformed the CI users (oh oh, not good). In fact many of the CI users needed two pitches to be at more than a quarter of an octave apart before the notes sounded any different. Not good. In western music you need to be able to hear a one semitone difference.
After reading this article, I checked what my skills were like using a CI only. I had my brother play a bunch of two note pairs on a piano keyboard. My task was to say if the two notes were the same or different and then secondly which note was higher in pitch. For the notes above middle C, I was able to reliably report if the two notes were same or different even if they were only one semi-tone apart. I was about 80-90% accurate at identifying which note was higher or lower. For notes below middle C, I needed notes to be at least one full tone apart to get the same level of accuracy, but performance deteriorated as the pitches got lower.
So here’s the thing now. Looks like I am not getting good low frequency pitch perception with the CI which is so critical for music. Low pitches may not be that important for speech as the consonants are mainly high pitched and consonants give you speech intelligibility.
I therefore personally decided to use a hearing aid in my non-implanted ear. I hear music much better whilst using a combination of a HA and a CI. But is it just me? No. A study be El Fata et al (Audiol Neurootol. 2009;14 Suppl 1:14-21. Epub 2009 Apr 22) looked at 14 adults who continued to use a hearing aid in their non-implanted ear after getting a CI. Subjects were asked to identify excerpts from 15 popular songs, which were familiar to them. The presentations were done bimodally, with the CI alone and then HA alone. Musical excerpts were presented in each condition with and then without lyrics. Those subjects who had more low frequency residual hearing (> 85 dB HL in the lows) did much better on all the tasks with both a CI and an HA than either the CI only condition or HA alone.
Another study by Gfeller et al in 2007 (Ear & Hearing: June 2007 – Volume 28 – Issue 3 – pp 412-423) also confirms the need for better low frequency hearing for music perception. In this study, CI users which electrical only stimulation (the regular type of CI) were compared to subjects with a hybrid implant. The hybrid implant uses a shorter electrode array for giving you the high pitches whilst still using a hearing aid type of air conduction for the low pitches. Usesing low frequecny acoustic hearing significantly improved pitch perception compared with elctric only CI’s. But before you go rushing off asking for a hybrid implant, you need to know that not everyone can get one of those. You need to still have sufficient low frequency hearing.
So here’s what I can conclude from these articles:
1. The newer studies seem to show better music perception in CI users than older studies. This is most likely due to improvements in technology in which the newer implants give a richer sound than the older devices.
2. Music perception with a CI via electrical stimulation could still be improved. It seems to be related to the poor perception of the low frequencies.
3. If you still have some usable residual hearing in your non-implanted ear, use a hearing aid in that ear.
Performing live music in a band is like a dream come true for me. I still can’t believe that I am able to do this with my hearing loss. On one hand, I am a bit pissed that I have a hearing loss at all, but the fact of the matter is that shit happens to all of us in one form or another. Hearing loss is the hand that has been dealt to me, but I am going to play this hand the best I can. If it was not for cochlear implants, hearing aids and FM systems, I would have been really screwed. But I am not. This pictures are proof of that to me. I am one lucky dude.
Again, I must thank my friend and professional photographer Arsenio Santos for taking photos of the event. There were so many good ones to choose, but here are some of my personal favorites.
Thanks also to me awesome bandmates Deb, Luigi and Warren. I love you guys! Thanks also to my buddy Dave for doing the acoustic set. And one more shout out to one of my best friends in the world, Ryan Switzer from Massive Tank Studios, not just for doing the sound, but for helping me become a musician.
My friend and professional photographer Arsenio Santos was so kind to take pictures of our event. As you may recall, the first part of the show was a selection of acoustic songs. Here we see myself on acoustic bass, Dave on his 12 string, and Maxine vocals. Thanks Arsenio, the pics look awesome! Looking forward to seeing the other pictures!
Ok, this title is wishful thinking. Deafened, yes, but rock star, perhaps not. We did a gig to raise money for a friend and colleague Warren Estabrooks whose organization is called “We Listen International”. Warren and his team provide professional education, training and consultative services for professionals who work with children, teens and adults with hearing loss.
We started out the evening with some acoustic covers of some songs. I played my acoustic bass whilst my buddy Dave played his 12 string and sang. Later, my friend Maxine Armstrong, also an audiologist, did a beautiful rendition of Tom Petty’s Free Fallin.
My son’s Band Sticks and Stones were up next. They played all original material that they wrote themselves. Their sound is sort of “Indy” with jazz-like instrumentals. Absolutely fantastic stuff. If these guys had a recording contract, I am sure they would be hugely successful. Check out their You Tube stuff here. Also, you can download their songs here.
Finally, my bandmates and I got up to do about 18 songs. I am so proud to be playing with these guys, everyone put in such a fantastic effort. None of us are professional musicians, but we did our best to sound like it!
Speaking of professionals, special thanks to my good friend Ryan and his assistant Laura from Massive Tank Studios for doing the sound for the evening. I love you guys!
Interestingly, while it is fun and exhilarating to perform music and have folks cheer for you, it is also quite stressful. Why? Because nothing ever goes exactly as planned. The key is to not freak out, persevere, problem solve and find creative solutions. Lets take a behind the scenes look at the day to show you what I mean.
1 p.m.: Start loading up the PA system, speakers, stands, bass amp, bass guitars, mics, cables etc etc.
2 p.m.: Start unloading gear at Pub. First surprise. Only one outlet box for all the gear. Go and find more power bars and hope we don’t blow any fuses.
4:30. Go to Music Studio to rehearse Free Fallin with Maxine. Plan is to have two guitarist and one bass.
5:00. Maxine still stuck in traffic.
5:15. Rehearse with Maxine.
5:30. Rush home to change.
6:00. Go to Pub to finish setting up gear. Three cables are dead, need to find replacements. Deb, our singer needs a music stand. Call wife to get her to bring one. Forgot MyLink Receivers. Call wife again to get those.
6:30. My son has not arrived yet to do his set up and sound check. He’s still at the tattoo parlor getting two new tattoos. Really buddy? On the day of the gig? Is that a good idea?
7:00. Supposed to start, but still setting up. Someone has unplugged my TX300V FM from the Aux Out 1 and used it for something else. I don’t think so people. Deaf guy gets first dibs on sound. Plus its my mixing board, so I get to call the shots. Slightly tense conversations ensue, solution found.
7:40. We start to do the acoustic set that was supposed to start 40 mins earlier. First three songs are fine as we over-rehearsed these. Maxine comes up to do her song. Ryan was supposed to join us by playing guitar, but we ran out of inputs on the PA for another guitar. Bummer, because while I love my buddy Dave who is playing guitar, he is rhythmically impaired. Maxine sings like an angel, but I lose my timing. Sound man Ryan sees I am struggling and becomes my human metronome. I read his lips as he is counting out the time. While I am playing some other folks with Cochlear Implants are requesting the MyLink FM receivers I promised. Shit, they are still in my car. Cant’ get them now, I am playing (for Pete’s sake!)
8:00. Son’s band sets up to play. No sound check because my philosophical artsy son decided to get tattoos earlier. Their performance was fantastic, but the pub owners are complaining it is too loud. Trying to get drummer to play as lightly as possible so everything else can be turned down. All drummers are now unhappy. I think all drummers were all born as Bam-Bam Rubble.
8:10. I am using my son’s band as an opportunity to check my sound through the FM. I discover the compressor is set wrong. Knee point is too low, compression ratio is too high and release time is too slow.
8:25: Adjust compressor. Hope its ok. Run to car and get MyLink+ receivers. and hand them out.
8:30. Start to play first set with my band. Sound still not right. Mouth to Ryan the sound man to increase vocals to Aux Out 1. Reach behind me and increase knee point on compressor a bit. Raise output on FM but over did it. Sounds distorted. It is peaking in the red too much. Next song plan to lower it. Can’t hear Luigi, the guitarist now. Thankfully I know some basic chords on guitar, so I watch his hands to see what he is playing. Luigi sees this, and moves a bit so I can see him play better. He understands what I need. I love you man.
8:35. Discover I am not feeling the kick drum through my platform very well. Look at mic on kick and discover its too far away. Lower gain on FM. Better.
8:40. Move mic on kick closer, still not right. But now I remember why…Warren, our drummer, is trying to play quietly (Quiet drummer…is that oxymoronic?).
9:10: Finish first set, and take a small break. Decide to play second set without my shoes on so I can feel the kick drum better.
9:25: Start second set. Sound is much better now. I am feeling the kick drum on my platform through my shoeless feet better now. My timing improves. Tweak the compressor a bit more. Warren, the drummer, and I are communicating well via eye contact. We are finishing our songs well. If you pay attention to recorded songs, you will notice that they most pop songs don’t really end, but they are faded out by the recording engineer. Live music requires a definite end, and getting everyone to finish a song at the same time is one of the challenges of playing live music. We devoted an entire rehearsal to finishing songs!
9:50. Sound is perfect now. But that’s the last song. Bummer. We finally have everything perfect.
10:00: Everyone is very kind with compliments. Some of my brutally honest asshole “friends” also pay us compliments. Hey, maybe we were good? Actually, come to think of it, we were great. Everyone loves our singer Deb, and they should. She is a natural frontman (front-woman?) for a band. I love you Deb!
10:15. Tear down all equipment, load up cars, take equipment home.
11:30: Go to Deb the singer’s house for drinks.
12:30 a.m.: Son calls and says he needs to be picked up because his friends parents kicked everyone out of the house for being too rambunctious. Hey, they are teenagers, what do you expect?
1:30 a.m.: Come home and unwind.
2:30 a.m.: Go to bed.
Moral of the story. Nothing ever goes as planned so don’t expect it. Roll with it.