How to Hear Better in the Car


Hearing in the car is a challenging listening environment for people with hearing loss. The signal to noise ratios are less than optimal for maximum speech understanding. Moreover, conventional directional microphones are typically oriented for face to face communication which is not ideal when communicative partners are seated side by side or behind. Binaural directional microphones which can add an additional 3-4 dB of SNR improvement definitely require a face to face orientation in order to work properly. Finally, one cannot take advantage of lip-reading cues, especially if one is the driver. At night, the lack of adequate lighting negates the use of lip-reading cues for the passenger as well.

The noise levels generated inside an automobile can vary greatly by type of vehicle and the speed the vehicle is traveling. There are several websites available that list the interior noise levels of various automobiles. The data in the chart below, taken from http://www.auto-decibel-db.com/, is a sampling of several vehicles operating at various speeds.Noise Levels in Car

As you can see the noise levels can vary as much as 12 dB. Typically high end gas powered luxury sedans tend to have the lowest interior noise levels, while entry level automobiles and diesel cars tend to have higher noise levels. If we assume that speech is typically 65 dB in intensity, what then are the signal to noise ratios? In the table below, I have simply subtracted the measured noise levels from the 65 dB speech levels to obtain the SNR.

Noise levels in car 2 SNR

The next thing we need to consider is what SNR’s do people with various degrees of hearing loss need in order to communicate effectively. Below is the classic Killion data showing SNR’s as a function of hearing loss. Note that this is data for a typical adult. Children need higher SNR’s as do many geriatric clients. It is therefore ideal to actually assess a client’s speech in noise capabilities through a test such as the Listening in Spatial Noise Test – Sentences with the Prescribed Gain Amplifier, otherwise known as the LiSN-S PGA.

Noise levels in car 3 SNR Needed

Let’s look at a couple of examples of how to apply this information. The first example is a 40 year adult with a moderate sensorineural hearing loss. This gentleman owns a Honda Civic and frequently drives on highway of speeds 100-120 KM/hr. He is usually is driver rather than passenger Our chart indicates that the SNR at 100 km/h would be -1 dB and the SNR at 120 km/h would be -3 dB. The Killion data suggests that he will requires a SNR of at least 6 dB in order to understand speech. Which technology will work for him?

First there are conventional directional microphones that can only pick up speech from in front of the listener. This will of course not work in a car since a driver must face the road whilst driving and not the talker beside. Some hearing aids have the capacity to shift the directionality of the microphones to the side and in some cases stream the signal to the other side of the head that does not have an optimal microphone placement. The signal to noise ratio improvement that can be obtained from this arrangement is still the same as conventional directional microphone and is about 4-5 dB. This will be satisfactory for speeds up to 80 km/h, but not higher speeds.

What about a binaural directional microphone? Hearing aids with these features combine all of the microphones on each hearing aid to achieve an SNR of 8-9 dB. While this certainly fits the SNR criteria numerically, it will not work in this case as he is frequently the driver and must keep his head facing the road. Binaural directional microphones work in front only.

The final options are remote microphone technologies such as Bluetooth or FM (non-adaptive) or adaptive digital remote microphone such as the Roger microphones from Phonak. Since Bluetooth remote mics provide about a 10 dB improvement this will certainly meet the criteria.

But what happens if one needs a higher SNR or there is a need to hear multiple talkers? This is certainly the case with the next example. This is a 38 year old mother with two children. She frequently needs to drive her 2 children or her elderly parents to various appointments in her Ford Focus. She presents with a moderate-severe sensorineural hearing loss and the LiSN-S PGA results were in the red zone indicating that she needs SNR boosts of at least 15 dB. In this client’s case she could use a non-adaptive remote Bluetooth remote microphone for local 50 km/h city roads as this will improve the SNR from about 7 to 17 dB.   However, she will still experience difficulties hearing multiple talkers and at highway driving speeds. The only technology that can cover all of her driving listening needs would be an adaptive digital remote microphone.

Below is a picture of a set-up that I have commonly used for these situations. In it you see both communication partners using adaptive digital remote microphones that switch automatically between the talkers.  In this picture, we are using two Phonak Roger Pen transmitters.  These transmit both the talkers voices to receivers connected to hearing aids or cochlear implants.

Noise levels in car 4 Two Mics Pic

In summary, I would recommend that you and your hearing care professional look at the following critical pieces of information:

  1. What car do you drive ?
  2. Are you typically the driver or the passenger?
  3. Do you do a lot of highway driving?
  4. Do you need to hear multiple talkers?
  5. How do you perform on a Speech in Noise test.

Only when you have all the relevant information can you determine the best solution for listening in a car.

 

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Resolution Acheived.


This will be a quick blog post.  I have been in contact with the management at Spring Rolls and they have done the following.

  1. The have apologized for what transpired.
  2. They have agreed to add the appropriate signs stated that Service Dogs are welcome.
  3. They have agreed to provide sensitivity and awareness training for their staff.

Note that this is not just about complying with the Ontario Human Rights Code but also the Accessibility for Ontarians with Disabilities Act.  Specifically, as of January 2012, all providers of goods and services must comply with the Customer Service Standards.  I urge you to click this link for more details. 

I am pleased that Spring Rolls plans to take the necessary steps to ensure this experience does not happen to others with disabilities.  Thank you.

Discrimination Against Hearing Ear Dogs


Photo by Richard Lautens, Toronto Star.

Photo by Richard Lautens, Toronto Star.

On Thursday April 18th at around 12:30 p.m., I attempted to go for lunch with my two work colleagues at a restaurant called Spring Rolls.  When we arrived, the manager told us we could not bring my Hearing Ear Dog in.  We immediately informed him that this was not a pet but a Hearing Ear Dog and as such was legally entitled to come into the restaurant.  He still continued to refuse to seat us, telling us first that Health Code laws prohibit this.  We told him this was nonsense and in fact the law allows me to bring a Hearing Ear Dog into the restaurant.  He still refused, saying that we cannot have a dog near other customers.  Again, we pointed out this was nonsense as well and the law allows us to be served.  He then proceeded to suggest we sit on the patio or in an upper area of the restaurant that was closed, but he would reopen so we would not be seen near anyone else.  We rejected those two options.  First, it was not warm outside and did not want to sit on the patio.  Second, segregation is also a form of discrimination.  We don’t segregate on the basis of skin colour, gender, or anything else, so why should I be segregated because of reliance on a Hearing Ear Dog?

After about 5 minutes of arguing, and his continual refusal to serve us, we were forced to leave.  We then proceeded to be served without any problems whatsoever at Jack Astors.

Lets review what the Ontario Human Rights Code says.

Ontario’s Human Rights Code  is a provincial law that gives everybody equal rights and opportunities without discrimination in the social areas of:

  1. employment
  2. accommodation
  3. goods, services and facilities
  4. contracts
  5. membership in vocational associations and trade unions

The Code’s goal is to prevent discrimination and harassment because of many areas (race, gender, age sexual orientation etc.), including disability.  Section 10 (1) of the Code defines “disability” as follows:

“because of disability” means for the reason that the person has or has had, or is believed to have or have had,

  1. any degree of physical disability, infirmity, malformation or disfigurement that is caused by bodily injury, birth defect or illness and, without limiting the generality of the foregoing, includes diabetes mellitus, epilepsy, a brain injury, any degree of paralysis, amputation, lack of physical co-ordination, blindness or visual impediment, deafness or hearing impediment, muteness or speech impediment, or physical reliance on a guide dog or other animal or on a wheelchair or other remedial appliance or device,
  2. a condition of mental impairment or a developmental disability,
  3. a learning disability, or a dysfunction in one or more of the processes involved in understanding or using symbols or spoken language,
  4. a mental disorder, or
  5. an injury or disability for which benefits were claimed or received under the insurance plan established under theWorkplace Safety and Insurance Act, 1997

The two relevant themes are that I was discriminated in the social area of “goods and services” due to a “disability“.

Through various contacts, two media outlets were contacted and agreed to do a story on this issue.  The Toronto Star published an excellent article.  Here are the contents of the article.

Interesting how the manager has modified his story to the Toronto Star reporter.  The article states the following.

“At the Spring Rolls restaurant on Queen St. W., Rupinder Bahl told the Star the reason Stelmacovich and his friends were offered seats upstairs or outside was because the tables at the front were either occupied or reserved. Stelmacovich, however, says many of the tables up front were empty.

When the restaurateur was asked if he understood that under Ontario’s Human Rights Code Stelmacovich cannot be refused proper service, Bahl said the dog didn’t need to be inside because he had friends who could help. Asked if he refused proper service he said, “Of course not.””

Point of clarification.  The restaurant was almost three quarters empty.  He never mentioned the need for reservations, this is something he made up after our incident.  The only reason he offered the upstairs area was to segregate us.  This was a special area used for parties and events and was not open to the public.  There was absolutely no reason that we could not have been seated in the normal part of the restaurant.

In addition to this article, the CBC also sent a camera crew to interview us.  This segment appeared on CBC on Saturday April 20 on the local Toronto 6 p.m. news.  Here is a link to the story of the CBC website.

Again, he brings up the lie about reservations.  Here is the relevant quote:

“The manager of the Spring Rolls restaurant didn’t want to appear on camera — but over the phone he told CBC News it was never his intention to offend anyone. He said the empty tables were for other patrons with reservations and he offered to welcome Stelmacovich back with a free meal.”

I told both reporters from the CBC and the Toronto Star that I will not file a Human Rights Complaint under the following conditions:

  1. That he acknowledges that he made a serious mistake by discriminating against me.
  2. He apologizes for this error.
  3. That he guarantees that it will not happen again not only to myself, but to anyone who relies on a service dog.

He failed to do that.  As such, I will be forced to proceed with a formal Human Rights Complaint.

Some may wonder, why bother with the hassle? My experience recently in Ottawa is the reason.  Before, when I had Amie, my previous Hearing Ear Dog, I had some incidents with taxi cab drivers.  However, when I went again to Ottawa with Flora, all the taxi cab drivers were excellent.  I asked one driver what he knew about the rules on service dogs  and he replied “Yes, we have be clearly instructed we must take people with service dogs”.  Obviously someone took a stand, and by doing so, made my life easier.

Now it is time for me to return the favor.  So this is not about me, or Flora, and a free meal.  This is about all people who rely on service dogs and face this kind of discrimination every day.

Keep your free meal buddy.

Meet Flora my new Hearing Ear Dog


Flora 1

Well folks, we have a new working family member.  Meet “Flora” my Hearing Ear Dog!

Flora is a Flat Coat Retriever.  I never heard of this breed before meeting Flora (but then again, I never hear a lot of things…).    This is a fairly old breed.  Dating back to the early 1800’s, this breed was the most popular birding dog, before Labradors and Golden Retrievers were developed.

Flora with her cool camo vest to keep burrs off her beautiful coat.

Flora with her cool camo vest to keep burrs off her beautiful coat.

In appearance, the Flat-Coated Retriever resembles a black or brown Golden Retriever. Flat-Coats are often called the “Peter Pan” of retrievers. They generally mature more slowly than other dogs and maintain their puppy-like exuberance for years. In my experience, the best Hearing Ear Dogs combine intelligence, playfulness, and an eagerness to please.  So far Flora seems to be all those things.  I do notice that she while she is a responsive and sensitive dog, harsh corrections will cause her to shut down until I make amends.  She tried to eat some nachos off the coffee table, and I scolded her for that.  She marched into the corner to pout for 20 minutes until I encouraged her to come back into the room.

This is her usual happy-go-lucky face!

This is her usual happy-go-lucky face!

Flora is a tolerant and friendly dog.  She adores everyone, perhaps a bit too much.  Thank goodness for the “Halti” head collar.  These things are a godsend for anyone trying to control a large or busy dog. Flora is definitely both of those things. The Halti works off the theory that a dog does not like to walk with its head turned left or right. If Flora pulls the leash, or forges off in a different direction, the energy is gently transferred into turning Flora’s head, thus stopping the behavior.

Halti

Note that even though Flora may appear to be a bit of a spaz in public, this same energy and playfulness are what will make her a fantastic hearing ear dog.  Plus, she is only 14 months old; she is still a bit of a puppy.  For the record, for those of you who knew Amie my previous hearing ear dog, she also required the use of a Halti for the first 3 years I had her until she settled down.  Radar, my first hearing ear dog, was a breeze to handle in public, but he never had the passion for hearing ear dog work as Amie did.  So my point is that smart and playful dogs are the best Hearing Ear Dogs.

One thing I am working on with Flora is to curb her desire to jump up on everyone and kiss their faces (she is long enough to do that with most average sized people).  First, the Halti collar will get rid of most of this behavior.  Second, the rule for everyone is as follows.  If you want to pet Flora, she must be sitting first.  Training a correct behavior that is incompatible with the undesired behavior is better that a harsh correction.  So in this case, we will make her sit first, give her a treat for a reward (I will have them, not you) and then we pet her and say hello.  If she tries to jump up, I will restrain her with the Halti, and you must not pet her.

Flora, like all Flat-Coat Retrievers require a fait bit of exercise. Flora needs a give 45-minute walk, run, or other activity daily to satisfy her exercise needs. The nice thing though is that once she has her exercise, she enjoys relaxing with us at home.  So she does have the capacity to settle down.  As I like to run, this makes her a perfect match for me.  We have gone on 2 runs so far and it has been great!  I now have a buddy to run with.

I am also amazed at how loyal Flora is and how well we have already bonded after only a few days.  She follows me everywhere, even to the bathroom, which is not a wise thing to do especially after I have consumed some Chicken Tikka Masala with extra Pataks Hot Curry Paste.  I left her with the family yesterday while I went to the gym…apparently she just stared at the door for almost an hour waiting for me.  Here’s the picture my wife took…

Flora is waiting for me to come home...

Flora is waiting for me to come home…

Just as a final reminder why I have decided to get another Hearing Ear Dog, please click here to read my previous post on this topic.   If you are too lazy to do that, then I will sum it up again.  Without my CI, I hear nothing whatsoever.  Therefore for at least 10 hours out of 24, I won’t hear any sounds such as fire alarms, door knocks, alarm clocks or phone calls.  Secondly, the microphones of hearing aids or CI’s really work best in a 2-3 meter (6-9 foot) range.  So if I am on another floor of the house for example, my ability to hear sounds is very inconsistent.  Finally, there is the issue of signal to noise ratio.  Even if something is close by I can’t hear it if there are other competing sounds such as the television.

Some Rules for Everyone.

  1. Don’t feed Flora.  Anything.  Ever.  Don’t even ask me.  No exceptions.
  2. Don’t pet her unless you ask me.
  3. If I do allow you to pet her, she will need to sit first, and then you can pet her.  If she tries to jump up and kiss you, turn away.  This behavior should go away in time.

That’s really it for rules for you.

I want to thank Tracy Church and the Hearing Ear Dog Team at Lions Foundation of Canada for training such a wonderful animal for me.  If any of you are feeling the urge to donate money to a worthy cause, I cannot think of a better one.

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.

Elephant Shoes or I Love You…The Good and Bad of Lipreading.


Lipreading, or speechreading is the process in which we try to understand speech by observing the movements of the face, lips, and tongue of a talker.   Note that I say we “try” to understand speech.  It is not possible to fully understand speech from visual cues alone.  Here’s why:

All speech sounds can by classified by three parameters (see chart below):  Place, manner, and voicing.  Place of articulation refers to where the sound is made.  For example, the sounds /p/, /b/, and /m/ are all referred to as bilabials since they are produced using both lips.  The sounds /f/ and /v/ are referred to as labiodentals since the lower lip is placed between the teeth.  There are a whole bunch of sounds that are produced at the alveolar ridge, which is the little shelf jest behind your two front teeth.  With these sounds, the tongue is placed on this ridge.   The remaining sounds are produced further back in the mouth and are pretty much invisible to the eye.  These include sounds such as /sh/, /ch/, /g/,  /k/, and /h/.

Bilabial Labiodental Interdental Alveolar Palatal Velar Glottal
Stops Voiced /b/ bet /d/ dent /g/ goat
Voicedless /p/ pet /t/ tent /k/ coat
Fricatives Voiced /v/ vet /th/ these /z/ zed /zh/ garage
Voicedless /f/ fed /th/ think /s/ sent /sh/ sheep /h/ hot
Affricates Voiced /j/ jeep
Voicedless /ch/ cheap
Nasals Voiced /m/ met /n/ net /ng/ bang
Liquids Voiced /l/ let /r/ reap
Glides Voiced /w/ wet /y/ yell

The other two parameters are manner and voicing.  Manner refers to the type of sound produced.  For example, fricatives sound like air rushing or hissing.  Stops or plosives sound like a burst of sound.  It is very hard to see the manner of a consonant.

Voicing refers to the use of our vocal folds when we make a sound.  Try this little experiment.  Place your hand on your throat and make the /f/ sound and then the /v/ sound.  Don’t say these letters, make the sound.  You will feel your vocal folds vibrating for the /v/ sound, but not the /f/ sound.  This is of course invisible to the eye; we cannot see vocal folds vibrating.

Now lets look again at the sounds /p/, /b/, and /m/.  All three of these sounds will look pretty much the same via lipreading.  However they certainly sound different and more importantly, they change the meaning of the word.  If I say “pat”, “bat”, and “mat”, one cannot see the difference between these words.

So the reason that communicating exclusively via lipreading is difficult is due to two main reasons.  First, many sounds are produced at the back of the mouth and are completely invisible.  Examples include /h/, /g/, /k/, /ng/.  Second, many sounds look exactly the same because they are produced at the same place in the mouth.  The  consonants /p/, /b/, /m/ are a good example of that.

But lipreading can still be useful as a supplement to hearing.  Numerous research studies over the years have confirmed this.  Most studies show that while the scores of most people on lipreading tasks is typically quite low, it makes a great supplement to the auditory channel such that auditory-visual speech perception (lipreading + hearing) is much greater that auditory only.  In fact, I recall reading a study examining auditory only, visual only, and auditory visual speech perception in older adults.  Even though these adults scored 0% on visual only speech perception, their auditory-visual speech perception score was still greater than auditory only.

While I consider myself a pretty good lipreader, I have made some amusing errors over the years.  Here are some examples of embarrassing mistakes I have made. First sentence is what was actually said, and the second is what I thought was said.  It may also reveal the workings of my twisted mind.

What Was Actually Said:  My teacher is so cool, she plays the guitar.

What I Thought:  My teacher is so cool, she pees in a jar.

 

What Was Actually Said:  I am going to design you a tattoo.

What I Thought:  I am dying to touch you.

 

What Was Actually Said:  There is some nice grass over there for your dog.

What I Thought:  There is some nice ass over there…

So here is my advice when it comes to lipreading:

  1. Use it as a supplement to your hearing.
  2. Hearing is still the most important sense we have for communication via speech.
  3. If your are finding that you need to lipread a lot in quiet, you should consider getting assessed for a cochlear implant.  Lipreading all day long is highly inaccurate and very tiring.
  4. If you find yourself lipreading a lot when in noise, consider getting a wireless microphone system such as an FM system to help improve the signal to noise ratio.  Or get out of the noise.
  5. Training to improve lipreading skills is debatable.  Instead, focus on creating favorable conditions for llipreading.  Tune in next time to a discussion on how to enhance the conditions for successful lipreading.

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

The Cochlear Implant Experience of Another Deafened Audiologist


I have a friend and colleague, Dr. Nashlea Brogan, with is also an audiologist with a profound hearing loss.  She received a Cochlear Implant on July 23rd of this year and was activated recently on August 23th.  We have been emailing back and forth a bit about how things were progressing for her.  I asked her if I could post these exchanges in my blog.  I think you will enjoy reading about her experience.  

A few background notes:

1. Nashlea received the Med-El Cochlear Implant. 

2. Nashlea was born with normal hearing.  She believes her hearing started to decrease in her teens.  She was tested at age 14 and by 18 years received her first set of hearing aids.  Since that time her hearing continued to progressively deteriorate such that she lost most of her hearing in her twenties and early thirties.  

2. Med-El, Cochlear, and Advanced Bionics all use different numbers of electrodes in their CI’s. So when Nashlea talks about the 13 electrodes, thats the number that Med-El uses.  My CI is from Cochlear Corporation and has 24 electrodes.  Note also that the length of the electrode arrays differ between the manufacturers.  There is on-going debate as to what the optimal length and optimal number of electrodes should be which I am not going to discuss here, but I just wanted you the reader to be aware of this.

June 17, 2012

Hello Peter,

Well, I have my big day for cochlear implant surgery on July 23 and activation on August 23rd in London. I was expecting the surgery to be in the 2013 winter but they called last week with an opening for this summer, eek!!!!

If you have any advice or recommendations I would truly appreciate it.  I have to continue managing my Hearing Centre’s during this time and do not know what to expect or how to even possibly plan. How long is recovery? Did you work between surgery and activation? After you were activated when did you return to work? Many people reported that they were exhausted in the first few months from sound? Did you travel during the initial months? What was work like when you returned? Sorry for all the questions, I am trying to leave the month after surgery and 2-3 months after activation as open as possible, but I am a planner. Is there anything you would have done differently?

Hi Nashlea.

I am very excited for you!

1. Recovery: varies greatly from person to person. I had my surgery on a Thursday. Went home next day Friday. Was back at work Monday. Others get really dizzy and need a week or two off.

2. Yes I worked between surgery and activation. I only took one day off.

3. I was not exhausted from sound. But I was impatient. You need to really chill out and wait. It takes months to get full benefit.

4. Read my blog!!!!

Aug. 10, 2012

Hello Peter,

Thanks for the reply and I really enjoyed your Blog both from the cochlear implant perspective and as an Audiologist.

I had my surgery and all went well, they made a full insertion through the entire cochlea with all 13 electrodes of the Med-El. I wasn’t really myself until 10 days after surgery, I had a lot of ear pain 5-6 days post surgery.   I am also living with my FM system, I never truly grasped how difficult having monaural hearing was.  My FM system, has made car trips, dining, work and any public situation manageable. I don’t know what I would have done without it. So, next the step is activation on August 23! Now I need to learn patience.

Thanks again

August 29, 2012

Hello Peter,

Activation a dream come true.

I had my cochlear implant activated last Thursday.  Now, I had prepared myself for a difficult time, I was scared from talking to other people and not being able to wear my hearing aid for three months in my other ear. I had advised my receptionist that I wouldn’t be able to see patients until I could understand some speech, I was terrified.

Today, I feel like I won the lottery of life!!!!! The audiologist first tested all 13 electrodes from 250Hz to 6000Hz and I could hear all of them. Once I was activated both the Audiologist and my husband sounded like daffy duck or mermaids!!! That sound lasted only a few hours, we went to a restaurant after my appointment and I could hear the waitress, the music, the other people talking. It has since gotten better hour by hour.

My biggest and most rewarding moment of all this was my children. For the first time, I heard all my 3 year old girls little words!!! She hasn’t stopped talking to me since. I can hear my nieces and friends children talking. When they say mommy to me from behind or another room I hear them. Not hearing children was the hardest part of having a hearing loss for me. I was happy going to work, I did public talks all over Sarnia, I travelled, went out, the hearing loss was more of an inconvenience for these things. But with children I felt isolated and dependent on other people to help me understand what my 3 year old niece was asking me, even my own daughter! I was nervous going to my sons mothers day’s tea in SK because of me not hearing him singing, or if his friend might ask me something with the other mothers looking on.

No sounds have been too loud, all the environmental sounds are exactly as a I remember them. A little history on me, I was born with normal hearing, they think it started to decrease in my teens, at age 14 I was tested but not enough loss for amplification and by 18 years I received my first hearing aids (I had normal hearing to 1500Hz at that time), I have lost most of my hearing in my twenties and early thirties.

I just never imagined this…..its so wonderful and to think its getting better!!! The one thing that i have never heard or read about CI’s is how separate every sound is. I always felt with hearing aids that all the sounds were meshed together, for example I could hear lots of noises in a car, it was loud and made speech hard to understand but the sounds were all blended in one big ball of background noise. Now, I can hear all the indicators, the sounds the buttons make when you press them, the tires hitting the road or cracks, and the acceleration of the motor every time the gas is pressed, and speech is separate not competing with the car sounds.

I haven’t felt any background noise since the moment of activation, in restaurants, cars, and the mall. I hear all the sounds of people walking, talking, machines, music but I wouldn’t describe them as background noise like a hearing aid!

I could type forever. I feel so happy, so full of energy, I don’t even want to take the implant off at night. What an amazing and incredible device!!! What sounds should I go listen to today, ha ha!!

Well Nashlea, thanks so much for allowing me to share your experiences.  I want the readers to know that everyone’s CI experience is unique.  I had no post-surgical ear pain or dizziness, yet Nashlea did.  On the other hand, I needed months to achieve the benefits from my CI that Nashlea received in only a few hours.  Patience is the key.

Details about Nashlea’s Audiology practice:

Bluewater Hearing Centre
316 George St.
Sarnia, ON
N7T 4P4 Canada
Phone: 519.344.8887
Fax: 519.344.4873email:info@bluewaterhearing.ca

Where NOT to Leave Your Hearing Devices


I blew a gasket yesterday.  Not proud of it, but it served to reinforce some points about how much I love hearing.

It was a hot a sticky day…about 34C with the humidity (thats about 94 degrees F, my dear American readers).  I was assembling my new tree stand in the garage but I was sweating like polar bear in Florida.  First I took off my shirt.  I can do that now and not have people scream in horror.  Got a chance to show off my new tat in the process.  But I was still too hot and sweaty.  Even though both my hearing aid and cochlear implant are water resistant, I still don’t feel comfortable getting these expensive devices drenched in sweat.  So I took them off and put them both on the hood of the car.  I turned around and went back to my project.

Here’s my new back piece Tattoo. It doesn’t have too much to do with the story, but I needed a picture.

Meanwhile, my son is having a real hankering for some Indian food.  He earlier asked me for a couple of shekels for this..I gave him enough for himself plus extra for some butter chicken and naan bread for me.  Point is, I knew he was going to drive off at some point, so this is not his fault.

So I am working away in the garage with my back turned to the car.  After about 15 minutes I turn around to get a glass of water in the house and see that my wife has returned from her errands. I start to talk to her but say “Hang on,let me get my hearing aid and CI which is on the hood of the car….Holy S#@*!”.  I now realize the car is gone along with my hearing aid and cochlear implant.  I am cursing like a trucker…screaming like a banshee…swearing like a sailor…angry like a, well you get the picture now.

Half a block away we find the hearing aid.  But so what.  I barely hear with that thing, its the CI I really need.  We continue to search the road while at the same time we are calling and texting my son to stop driving and pull over.  I am still panicking.  I have mental images of my cochlear implant becoming road kill.  Finally, he gets the message. Turns out the magnet on the CI kept it stuck to the hood, even though he had been driving for 20-30 minutes.  He pulled it off the hood and brought it home.  The CI still worked despite bouncing around on the hood of a moving vehicle.

 

Lessons learned:

1. Don’t put expensive hearing devices on the hood of a car.  Duh!

2. Try not to curse too much when you can’t hear.  You can’t monitor your loudness.  Turns out the whole neighborhood heard me.  (Sorry folks.  But maybe you learned a few new fascinating words? They may come in handy later.)

3. Boy do I I love to hear.  So much so, that the thought of having to wait a few days to get a replacement CI freaked me out.  I can go an hour or 2 without hearing, but not more than that.

4. I still wish I never needed these things.  Normal hearing people can sweat, swim, get dirty and still hear just fine.  But there is no point wishing for something thats never going to happen.

5. I was very lucky yesterday…maybe I should go out and buy some lottery tickets.

My fellow people with hearing loss or parents of kids with hearing loss…do you have any stories like this to share?

Bear Encounter with a Deafened Dad


An Ontario Black Bear

I have had several opportunities this summer to camp in one of the most beautiful places on earth: Algonquin Provincial Park.  It is located about 3 hours north of Toronto and is pretty big.  It is 7,725 square kms which, for my American friends, is about the same size as the states of Delaware and Rhode Island combined.   For my European friends, that is about one quarter the size of the country of Belgium.

Algonquin Park has over 1,500 lakes and 1,200 kms of streams and rivers.  It is also the home of lots of wildlife.  I personally have seen many species of wild animals in Algonquin Park including beaver, huge moose, deer, wolves, and finally black bears.  It is an encounter with the latter animal, Ursus Americanus, which serves as the inspiration for this story.

For years I have camped in Algonquin and never once saw a bear.  But in 1999, the spring bear hunt was cancelled in Ontario.  Some say that this caused the population of black bears in Ontario to rise from 100,000 to over 250,000.  Others argue the increase is smaller than that.  I am not going to go into the reasons why they cancelled it or whether I agree with it.  But needless to say, when the bear population grows over 150%, the chances of encountering a bear increase.

So, a few years ago, my son (who was about 12 at the time) and I decided to do some backcountry country camping in Algonquin.  We packed up our gear, loaded the canoe on the car and off we went.  We selected a lovely site on a lake so we could swim and fish.  We had just finished an afternoon swim and I was starting to make dinner while my son went to gather firewood for a campfire.

Of course, I did not have my cochlear implant on because I was still drying off from the swim.  I was barefoot and just in my bathing trunks.  Delicious meat with no wrapping on it.  I turned to go to the tent, which was about 4 meters or 12 feet behind me, to get a t-shirt.  And there he was..Big George the Bear as I later called him.  George was just sitting there beside the tent and staring at me, probably wondering why I was so calmly ignoring him up until that point.  Well George, you snuck up on a deaf guy that’s why.

This is not George, but looks almost exactly like him. George has a green ear tag.

He was a beautiful bear with a gorgeous coat…but I would have preferred to see him on a high definition television or in a zoo like 99% of the rest of the sheltered world.  I was close enough to see that he had a green tag in his ear.  This indicates that he had already been tranquilized, tagged and relocated for bugging people.  Well, I guess George wanted some more Doritos from the car campers which were only about a one hour paddle away.

Note that George was not interested in anything I had in the tent.   I am a very careful camper.  All food and toiletries are safely suspended high up in a tree and not in the tent.  You would be surprised what bears consider to be food (which is almost anything).   I have heard of people leaving Preparation H hemorrhoid cream in their tents only to come back later and find a bear happily munching away on the tube.  Yuck.

After my initial surprise to see a wild bear right behind me, my thoughts turned to my son.  Where was he?  Should I call out to him? But I did not have my CI on so I would not hear a thing if he responded.  I stupidly forgot to bring bear spray or bear bangers with me.  For those unfamiliar with these protective devices, bear spray is a large can of  pepper spray under high pressure.  If needed, you can squirt it into a bears face and it will take off but in intense pain.  I had the unfortunate experience of spraying a tiny amount into the wind and having it come back at me.  It was extremely painful even though the amount was only miniscule.  Pepper sprays such as bear spray is actually illegal in many parts of Europe, but that makes sense.  Why would a European ever need it? There are no dangerous animals there.

Bear Spray

I recall reading about what to do if you encounter a bear.  Note that your strategies for black bears will be different than brown or Grizzly bears.  Black bears are excellent tree climbers so don’t bother trying that.   With Grizzlies, you more or less play dead and pray to what ever Deity you worship.  With black bears, I have read, you actually try to make your self appear big and scare it away.

Black Bears are excellent climbers…so don’t climb a tree!

So I made my decision.  I was going to scare the bear.  If he ran, great.  If not, at least my son would be protected, he could have me.  Believe me, there is plenty of meat on me, particularly back then when I was a chubby deaf guy.  So I grabbed the pot I was boiling water, dumped out the water, got a spoon and started banging it while at the same time roaring at the bear.  I must have been quite a sight.  Shirtless, shoeless, chubby white deaf guy chasing a bear with a pot and a spoon whilst dropping F bombs.

The thing ran so fast.  I heard bears are fast runners, but to see it live with my own eyes was something else.  But most importantly, my son was safe.  He returned out of the woods with a look on his face that said “That’s it, my old man is now crazy”.  He never did see the bear himself.

So what did I learn from this experience?

1. I am very proud that my first instinct was to protect my child.  We all hope that we will do so, but it is nice to have been tested and passed.

2. I never go into the backcountry without bear spray and bear bangers now.  This is of particular importance to a person with hearing loss.  In humans, hearing is the best sense we have for detecting danger.  It works 360 degrees, 24 hours a day, 7 days a week.  Our other senses can’t match hearing for danger detection.  So, all the more reason for a person with hearing loss to protect oneself whilst in bear country.

3. It is true what the experts say about what to do if you encounter a wild bear.  I would suggest reading up on that if planning a trip to the back country.

4. But I am not afraid of bear encounters, just respectful of the animal.  Statistically speaking, I have a greater chance of being killed on the highway while driving up to the park.  Just keep the campsite clean, store food and toiletries up in a tree, and bring bear spray for protection.

Here are some pictures of a recent trip my son and I did on Algonquin.  Enjoy!

Sunset in Algonquin from our campsite

My son Alex filling his head with knowledge.

That’s me in my kayak.