On Being Normal…


As a person with hearing loss, I often ponder the question of what it means to be normal.  Does my cochlear implant give me normal hearing again?  Am I a normal person?  If not, am I less of a person because not everything about me is normal?

For any hearing aid or cochlear implant user, I think no one will ever have normal hearing again.   There is some form of damage in the auditory system that cannot be corrected.  For example, in cases of sensorineural hearing loss, the hair cells remain damaged even after we add the hearing devices.  Until hair cell regeneration therapies become clinically available, the ear is still not normal.

Some people have compared using hearing aids to using eyeglasses to restore vision.  While it is tempting to draw such an analogy, I do not think this comparison works.  For most people with glasses, there is nothing damaged or unhealthy about the eyes.  Typically, the lenses of the eye are simply not the correct shape but the eye is still healthy.  Moreover, eyeglasses do not convert the light energy from one form, digitize it, manipulate it and then attempt to reconvert it back into light energy again.  What hearing aids do is far more complex than eyeglasses.

What we can do when it comes to hearing loss is try to restore normal function. By this I mean we can use equipment and communication strategies to allow us to function better in the various communication situations we face.

In cases of milder hearing loss, we try to restore the normal function of the outer hair cells via sophisticated hearing aids that amplify softer sounds more than louder. We try to restore normal ability to hear in noise via directional microphone technology or additional wireless microphones. We try to restore normal audibility of high frequency speech sounds via techniques such as non-linear frequency compression.  When hearing aids no longer help, we try to restore normal audibility via a cochlear implant.

But at no point are we ever making hearing normal.  The ear is still not the same as someone with a fully intact auditory system.  The extent to which we can normalize function is contingent upon many factors such as the degree of hearing loss, the technology employed, the behaviors we use and sadly financial resources.

Clearly, the more severe a hearing loss is, the more challenging it will be to communicate even with the best equipment currently available.  Also, if one has a more severe loss and chooses not to utilize the proper type of amplification for the hearing loss including wireless microphones, then such a person will also not function as well in all situations.  This also relates to behaviors.  Learn to how to use the equipment in various situations.  Learn how to communicate effectively.  Teach others how to best communicate with you.

Ok, so my hearing is not normal.  Does that make me an abnormal person?  Maybe, but frankly who on this planet is completely normal.  If you are not the ideal weight, not the ideal height, take medications for some medical condition, you too would not be perfectly normal either.  But so what?

I do not worry or care about being perceived as normal because frankly very few people on this planet are normal.  But just because I am not “normal”, this does not make me less of a human being.  I still want all the things anyone else wants in life.  I do not want to be discriminated against nor denied things simply because of my hearing loss.

So lets not even worry or talk about being normal…it is an impossible quest.  Lets learn to embrace  and accept all of the things that make us different and make us who we are.

Top Ten Reasons Why I Need a Hearing Ear Dog


As many of you are aware, my sweet dear Hearing Ear Dog Amie passed away on June 13 of this year.  Initially, I did not even want to think about getting another dog.  As a family, we all needed time to grieve the loss of such a special friend.

Are we over the loss of Amie yet?  Absolutely not.  But I think I can now start to think about  getting another Hearing Ear Dog.  This is of course not about replacing Amie.  That is impossible.  But our hearts are certainly big enough to make room for a new dog to become part of our family.

One interesting thing that has happened to me over the few months is other people have also enquired as to whether I will get another hearing ear dog.  Interestingly, the question is not always posed the same.  In fact, they can be classified into three categories.

First, are the “Genuinely Curious”.  These people are truly just asking out of interest.  They do not hold any biases or preconceptions.  They are not fully aware of the impact of hearing loss in general, nor do they fully understand my particular details.  To these people, I do not mind explaining both my situation, the nature of deafness, and the role of hearing ear dogs.

The second group I call the  “Erroneously Positive”.  These people may make comments like “I really do not see you as deafened” or “You seem to be doing just fine”.  Generally, I do not sense any animosity or ill will.  Instead, I believe these people are actually complimenting me.  They judge my degree of disability (or rather lack of disability) on my functional abilities in a one on one conversation, rather than the results of my audiogram.  Interestingly, this flies in the face of the so-called ‘hearing aid effect” in which people with larger hearing aids are judged less positively than those with smaller devices.   These studies were done with photos.  I believe that showing static photos bears no relationship to the real world of communication.  Here I am with a cochlear implant, bigger than the biggest BTE hearing aid from 25 years ago, a hearing aid in the other ear and an FM system in my hand and yet folks don’t think I have that much of a hearing loss at all.  Its quite remarkable really.

The third and last group are what I call the “Ignorantly Hostile”.  Sadly there are quite a few of these people.  They make judgmental comments laced with suspicion and almost hostility.  They make comments like “Yeah, but you don’t really need a hearing ear dog…you just want a pet”.  Some comments are just ignorant, not so much hostile but annoying nonetheless.  Example “Now that you have your cochlear implant, you don’t need Amie anymore, right?”  I am not alone…I have read similar stories from other CI users.  For example, a CI user named Denise wrote “So? If you have a cochlear implant now, why do you need a dog? Didn’t that (as she gestured towards my CI and bling) fix you?”

One thing that many CI users would like others to know is that the cochlear implant is not a cure for deafness.  We have artificial battery operated ears that does not sound like normal hearing (See What Does a Cochlear Implant Sound Like).  It has an electronic microphone that does not have the same sensitivity as the normal ear.  Hearing aid and cochlear implant microphones work best in a 3-5 foot range.  Moreover, the CI or hearing aid does not have the same capacity to filter out noise like the normal cochlea.  Lastly, we cannot wear these devices 24-7.  When we sleep at night we are even more deaf than we were before we got our implants!

To illustrate the limitations of microphones, try this experiment.  Stand about 20 feet (6 meters) from another person.  Have a recording device in your hand.  Most mobile phones have a voice recorder.  Now have the other person speak to you and record their voice.  Did you hear and understand ok?  I am sure you did fine.  Now play it back the recorded version.  Listen to how thin it sounds and how much background noise there is.  Now do it again, but add some additional background noise from say a stereo or TV.  Listen again to how much harder it is to understand the recorded version.

Welcome to the world of people with hearing aids or CI’s.  This little experiment only shows the limitations of electronic microphones.  It does not even address the lack of noise filtering of our impaired auditory systems.

In short, here is tonight’s Top Ten List entitled “Reasons Why I Still Need a Hearing Ear Dog”

1. When I sleep at night, I take my CI off and I hear absolutely nothing.  I need to wake up to get to work in the morning and a regular alarm clock will not work.  Vibrating alarms are not bad…but read on.

2. Similarly, most fires occur at night when people are asleep.  Studies show that visual fire alarms do not work effectively in waking people up (see this article on Waking effectiveness of visual alerting systems ).  A hearing ear dog will physically wake me up.

3. I travel extensively for my work and I cannot take a suitcase full of technical devices with me everywhere I go.  I am not sure how I can hook up these devices to the main fire alarm of a hotel anyway.

4. I have had hotel staff march into my room while I was in my birthday suit.  I did not hear them knock.

5. Hearing aid and CI microphones are not as sensitive as natural hearing.  So I am hit and miss with sounds.  The hearing ear dog will ensure consistency.

6. Many times the sounds I need to hear (doorbell, phone, microwave etc) are not at an adequate signal to noise ratio for a person with hearing loss.  It is buried under noise making it impossible for our damaged cochlea to detect.

7. If I know someone is coming to my house and I am alone, I must sit and wait on the main floor in order to hear them knock or ring the doorbell.  I can’t reliably hear these sounds from another floor of the house.

8. I sleep better at night knowing someone is there listening for me.

9. Traveling is actually easier with a working dog, at least to the countries I go to.  It reminds airline staff I cannot hear the announcements to board so they come get me ahead of time for pre-boarding.

10.  Hearing ear dogs help to filter out the assholes of the world.  If you don’t like dogs, I won’t like you.  So I get to find out a serious flaw in someone’s personality a lot faster.

For more information on Hearing Ear Dogs see the links below:

Lions Foundation of Canada

Pacific Assistance Dogs Society

Research on Music Perception with a Cochlear Implant.


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.

4. Help your ears by making music easier to hear.  Use some of the techniques I use by adding FM technology to your CI and hearing aid for either live music or with an iPod.

More Gig Pics…


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.

Deb is such a passionate singer.

Looking cool in a B&W photo

Warren is a fantastic drummer.

Luigi singing and playing guitar. You are awesome Luigi!

I am having a good time, can you tell?

But I do need a haircut.

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.

10 New Years Resolutions for People with Hearing Loss


Here we go again…its that time of year where we make all sorts of cliche New Years resolutions.  We all make the typical “lose weight” “exercise more” types.  Those are permanently affixed to every year’s list of resolutions for me.

As a person with significant hearing loss, there are some things which we can do that will make our lives more enjoyable.  So here are some suggestions for New Years Resolutions.

  1. Develop and Enjoy a Hobby.  As people with hearing loss, our communication challenges affect us in so many ways.  Its easy to let this dominate our lives.  So this is why I put this one at the top of the list of resolutions, because I feel it critical to develop and nurture our entire person.  For me, I have taken up Archery.  I love how archery calms me.  In addition, It requires much practice and skill, so it challenges me.  And it completely takes my mind off my hearing loss.
  2. Learn to use a new Communication Device.  Have you tried captioning on your TV?  Have you tried an FM system?  Do you use your different programs on your hearing aid?  This year, make it a goal to pick a device and learn to use it well.
  3. Learn a New Communication Technique.  There are all sorts of behavioral ways we can learn to communicate better.  Technology is only part of the story.  Ask yourself questions such as “Do I always make sure I sit with the light behind me so I can see other people’s faces better for lip-reading?”, or “Do I use a specific clarification rather than just saying what or pardon me?”.  Pick just one technique and try to apply this as much as you can.
  4. Take Action. This involves learning to be assertive, but not aggressive.  I need to work on being a bit more assertive.  For example, when I sit in a restaurant, sometimes I do not pick the best seat.  The best seat would be one in which I can see as many faces as possible and where the background noise is behind me.  All I need to do is just say to my dinner party “Do you mind if I sit there?  It would help me communicate better.”
  5. Learn to Accept Things.  Even with all the best technology and communication techniques, there are certain situations that may still be too challenging.  For example, even though I may go out to a bar with friends, I cannot hear all the communication from all the people in my group.  With the use of my FM system, I can, however, have conversations with one person at a time.  Therefore I have learned to accept this limitation.  I wish I could hear all the jokes zipping around me, but I can’t.
  6. Develop Calmness.  Again, another one I need to work on.  I am getting better, but sometimes I do get frustrated by my limitations.  Normally, this drive I have to not let this hearing loss limit me is a good thing.  It has driven me to become an audiologist, and learn to use all sorts of technologies and strategies to communicate better.  But sometimes, we might hit a brick wall.  I can get worked up by this and boil inside and its not healthy.  This year, when I get that feeling, I will try to draw upon the calmness I am learning from Archery. (See how this all ties in together?)
  7. Teach a Loved One Communication Strategies.  Communication is a two way street.  I would say that perhaps unlike other disabilities, hearing loss always affects your love ones.  Talking always involves at least one other person and as such, requires changes from communication partners.  So take some time to teach one “significant other” some techniques.  For example, my niece is likely the fastest talking teenager on planet earth.  It is incredible how many words per minute she can say.  I have worked on getting her to slow down when talking with me. Interestingly, she is now working as a waitress saving money for University next year and she has found that she does her job better when she slows down her speech for her customers.  Win win!!
  8. Plan a Dinner with Good Communication Techniques.  This one is a fun project.  Scout out a restaurant that is low noise and has good lighting.  Pick out a table that also fits these two criteria.  Pick out a seat that allows you to see everyone and where your back is towards the background noise.  Decide the number of people in the dinner party that you comfortably can communicate with.  Think about the communication devices you will be using, such as an FM system.  Think about the request for clarification techniques you will employ. And then make a reservation and enjoy!
  9. Read.  For the majority of us, our sense of vision is just fine.  Our eyes are an unimpaired portal to information.  The more we read, the more we keep in touch with the world around us.  Topics become more familiar, which assists greatly in lip-reading and hearing.
  10. Take Time for Family.  Here’s another one for me.  I get so wrapped up in dealing with my own hearing loss issues, that I sometimes do not see how things are with my family.  Be sensitive to how your hearing loss affects your other family members.  Be thankful for the things they are already doing to help you.  Also, your family members have things happening to them, both good and bad.  Make sure we take time to listen to them, rejoice in their successes, and help them with their challenges.  Its not always just about us.

Stigma and Hearing Loss.


Over the past year, I have been growing my hair.  I have done this for a couple for reasons.  First, I am still in the midst of a mid-life crises, but in a good way.  I am celebrating the fact that I still have a full head of hair at 47, and I am showing if off it a silly display of vanity.  Second, it looks good when I am playing in my band (its great for head banging).  But thirdly, I must confess, is that it is helping to conceal my hearing devices.  The latter was not one of the initial motivating reasons to grow my mop, but I have noticed a change in the way people look at me now that the devices are less visible.

People tell me I look like Matthew McConaughey's chubby, but sexy, deaf brother.

So what is the issue here?  Obviously there is still a stigma associated with hearing loss.  Lets look at the definitions of this word “stigma”.  The Merriam Webster on-line dictionary defines stigma as “a mark of shame or discredit” and “an identifying mark or characteristic; specifically : a specific diagnostic sign of a disease”.

So do I see using a hearing aid, a cochlear implant or an FM system as a sign of shame or discredit?  Of course not.  In fact Canadians, Americans, Europeans, Australians, and others who live in the developed world should realize how fortunate we are to be living in a society in which our either our incomes or social programs can afford to provide us with devices that can help us hear again.  World wide, there are likely millions of individuals with hearing loss who cannot afford the luxury of better hearing.

Are using hearing devices a specific diagnostic sign of a disease?  Well, maybe.  It certainly does give away the fact that I do have a hearing loss.  But as I will point out later, there are other signs that indicate the presence of a hearing loss, namely, one’s communication abilities.

I think that for many years, hearing aid companies did not help to diminish the perceived  stigma associated with hearing devices.  They constantly tried to advertise “invisible” hearing aids.  One could even order hearing aids that were delivered to your home in a “plain brown envelop”.  What’s up with that?  Are we ordering porn here? These kinds of marketing practices only served to reinforce the notion that hearing loss is shameful.

Frankly, I think most of the notion of hearing aids being stigmatizing on an individual is bullshit.  The ultimate proof of that comes to me every year around Christmas time in which I go to lots of Holiday parties.  What I am about to describe to you has happened to me so many times, I wish had a nickel for every time it occurred.

The scene is set as follows.  I have my refreshing beverage in my right hand.  In my left hand is my Phonak SmartLink+ FM transmitter.  I am happily conversing away with lots of folks, and inevitably, someone will ask about it.  The conversation goes something like this:

Other Person: “Hey, what’s that thing you got there?”

Me: “Well, that’s my FM transmitter”

Other Person: “Oh yeah, so what does it do?

Me: “”It picks up your voice and helps block out the background noise.  so I can hear you a lot better in this noisy party”

Other Person: ‘Wow, cool.  so how do you hear with it?”

Me: “Well, it transmits via FM radio waves to little receivers attached to my cochlear implant and my hearing aid”

Other Person: “Wow, thats so cool.  You know my Dad should get one of those.  His hearing is way worse that yours”

Me:  “Really?  Wow. His hearing is worse than mine?  Is he deaf?”

Other Person: “No, no , no.  He’s not deaf.  Probably just hearing loss due to age.  But he just completely falls apart in social gatherings.  He totally avoids them.  Constantly saying “what?” all the time.  Drives us all crazy, especially my Mom.  He won’t even go to things like this anymore.”

Me:  “Does he wear a hearing aid.”

Other Person:  “No, he doesn’t want anyone to know he has a hearing loss.”

So what do I conclude from this exchange?

  1. People judge the amount of “disability” you on the basis of your behavior and your ability to function, not just on the presence of hearing devices.
  2. Because I seem to function better in a noisy environment with my FM system, hearing aid, and cochlear implant, I am perceived as having LESS of a hearing loss than a silly old coot with presbycusis (hearing loss due to age) who won’t even wear a hearing aid.
  3. Often the biggest barrier to better communication is the person with hearing loss themselves.  They erroneously think others won’t notice their hearing loss if they do not wear a hearing aid or use an FM system.  The fact is that they are constantly having communication breakdowns and this is extremely obvious to everyone.

But this brings me back to the hair thing.  The cochlear implant is bigger than a hearing aid, so folks do stare a bit.  It can get annoying.  So, I grew my hair a bit and it covers it up more.  So shoot me for wanting to look a bit cooler.  But I can assure you, I would never trade my ability to function for the sake of cosmetics.  I know that I would be perceived far worse if I kept saying “what, huh, pardon me”.  The hearing devices and FM system help me function and decrease negative perceptions.

Listen to the Music Live!


This post is the second part of my description of how I listen to music when I play in my band.

Just a quick review of the challenges I have hearing the music correctly.  Most of you who also have significant hearing loss will likely have these issues as well.

  1. The music can sound muddled and unclear due to the reduced frequency resolution of the impaired auditory system.
  2. Music can sound distorted since hearing aids and cochlear implants cannot always handle loud inputs.
  3. I need to hear my own instrument, while at the same time need to hear the rest of the band clearly.
  4. I need to keep in time.

The latter problem of keeping in time is solved by the platform I made.  See the previous posting for a description on that.

Through lots of trial and error I have come up with a system the finally works for me.  It allows me to hear my bass guitar, while at the same time hear appropriate cues form the guitarist and vocalist.

  1. First my bass goes into my Boss TU-2 Tuner.  Using an electronic tuner has made tuning the instrument a breeze.
  2. Then the signal goes into the Big Muff Pi Distortion Pedal.   I use distortion sparingly, but what I like about this pedal is that it splits the signal into two parts.  A dry unaffected output and a wet affected signal.
  3. The wet affected output then goes into my Markbass 800 Watt Bass Head and speaker cabinets.  This is what the audience hears.  But not me, I only feel this.
  4. The dry signal goes to a Boss GEB-7 Bass Equalizer.  This allows me to shape the signal so that i can hear it better.  I seem to hear the bass better when I enhance the frequencies between 400 Hz to 800 Hz.
  5. Next the signal goes to Boss LMB-3 Bass Limiter.  I need to ensure I get rid of harsh peaks that would sound distorted to me.
  6. The signal now goes into the SansAmp Bass Driver DI to bring the signal up from a weak signal to a line level signal.
  7. Finally the signal goes into the Phonak TX300V Studio Transmitter.  This send sthe signal to me to hear.

But wait, we are not done yet!  I also need to hear the rest of the band correct?

  1. The guitarist amplifier, guitarist background vocals,  and the main vocalist are all being picked up by their own microphones and fed into the PA system.
  2. Their is an auxiliary output on the mixing board.  I adjust the individual auxiliary output volume controls so that I hear the exact amount.  Generally, with the pop music we play, I like to hear more of the main vocalist.
  3. This then goes into another compressor (oddly enough called the Really Nice Compressor).  I then adjust the kneepoint, attack time, and release time so that the loud signals are lowered and the weak signals are enhanced.
  4. This signal also goes into the Phonak TX300V Studio Transmitter.

The final step is blending the bass signal (my instrument) and the rest of the band.  The TX300V is nice in that it has 2 channels of input and a blend control.  I can now belnd and adjust the two signals to my liking.

So that’s how I do it folks.

How to listen to your iPod…


If you have a hearing loss and you want to listen to music on your iPod or similar device, you have a couple of options.  But each has advantages and disadvantages.

  1. Take off your hearing instruments and listen via headphones.  This only works if you have a fairly flat hearing loss.  But if you have a different amounts of hearing loss at different frequencies, then the music will sound weird.  For example,if you have a high frequency hearing loss, then the music will sound like too much bass.  Also, the hearing instrument has a maximum power output that has been set by your audiologist.  When you take off your hearing aids and listen only via headphones, you might damage your hearing.  So I do NOT recommend listening via headphones.
  2. Use a DAI Cable and Proprietary Audio Shoes.  This option works with behind-the-ear (BTE) hearing aids with direct audio input (DAI) capability.  The advantages of this connection are that the music will be shaped to meet your hearing loss configuration.  Moreover, the loudest sounds cannot exceed the maximum power output of the hearing aid as set by your audiologist.  Therefore, this is a safer option.  Lastly, these cables preserve the stereo separation, so you will enjoy the left and right panning in the music.  The disadvantage is of course that you have a cable.
  3. Use a Streaming Device. These kind of devices are made by several hearing aid companies.  This link here shows the one made by Phonak called an iCom.  These devices are cool in that they wirelessly send a stereo signal to all kinds of hearing aid styles, not just BTE’s.  Here is a picture of an iCom.
  4. Use an FM System.  This is the option that I use.  The reason is that I cannot use any of the previous options since I wear both hearing aid and a cochlear implant.  I cannot get one cable that works with both devices simultaneously.  I also cannot use an iCom as that only works with the hearing aid.  So I plug in my iPod into my FM system and this transmits the signal wirelessly to my receivers.  It works with both my cochlear implant and hearing aid.  It is also a very safe option.  The only disadvantage is that the FM signal transmits in mono, not stereo, but that’s not too big a deal.  Here is a link to some FM options.  And below is a picture of the FM system that I use:
This is the transmitter called a SmartLink+
 This is the Naida UP hearing aid with the FM receiver (green circle) added on the bottom:
This is the Freedom CI again with an FM receiver (green circle) added on the bottom:
Lastly, there are some cool things to do with your iPod to make it work better for you.  See this link on iPod accessibility and hearing.

What’s it Like to be Deafened?


What’s it like to have a hearing loss?  What is it like to hear with a Cochlear Implant?

People often ask me this question, and it is not easy to answer.  So I thought I would take one of my photographs I took while hiking in the Rocky Mountains and play with them to try to illustrate with it is like.

Let’s look at the photo untouched.  This would represent normal hearing.  You see all the colours and the detail of the mountain.

Now the next picture would represent someone who would be considered “Hard of Hearing.”.  You can see the picture is blurry and unclear.  Similarly, someone with a mild to moderate loss of hearing would still hear things, but the words would not be clear.  Hearing aids with directional microphones, and the addition of an FM system can help restore the loss of this detail.

The next picture represents what it is like to be deafened.  Note that you can still barely detect something, but not much.  Similarly, someone who is deafened can barely hear anything.

This next picture is what it would have been like to hear with one of the early generation Cochlear Implants from 10-15 years ago.  We can see that it is a mountain again, but only a basic representation.  The colour and detail are not present.  Similarly, these early implants did help people to hear speech again and when combined with lipreading, was a very helpful device.

The next image represents to me what it is like to hear with my combination of a modern cochlear implant and hearing aid.  It is getting closer to the original image.  You can see that this is a mountain again.  However, it does not have the same detail as the original image.  It is a simplified representation.  Similarly, I can hear things that are said and can understand most speech in quiet.  But the sounds do not have the same richness and detail as when I had more hearing.

This is, of course, a very crude and oversimplified representation of what it is like. Nonetheless, sometimes simple explanations are also useful to help us understand.

I am extremely grateful that there is technology that can help me hear again. For a deafened adult who once had more hearing, a silent world would be devastating.  My use of a cochlear implant, hearing aid, and FM system have made a huge difference in my life.  Yes, it is not the same as normal hearing.  These devices are not cures.