Amie, Bass Guitars, and Good Health.


I have not posted in a while.  I needed some time off.  Amie, my sweet friend and hearing ear dog passed away on June 13.  She was such a big part of our family; her passing hit us all pretty hard.  I wrote many tributes to her already in my blog, you can read them here and here.  Amie, we miss you terribly.

Two happier items to talk about.  My band played another event on Saturday July 21st.  We raised over $800 for the Multiple Sclerosis Society of Canada.  This time I really got the sound right.  I had all the settings tweaked really well so I could hear exactly what I needed.  Moreover, what pleased me most was my ability to keep playing the correct parts when our singer deviated from the song.  I was able to hear that we were not at the part of the song I expected and still played correctly.  In addition, my guitarist was able to glance over at me and mouth instructions.  It was such a massive confidence booster to know that we can screw up but still recover without anyone in the audience even knowing it.  For more information on how I play live music with my hearing loss click here.  Also, this link here talks about how I keep the beat.

Also, I continue to improve my health.  I started in March at about 260 lbs and I am now 221 lbs.  I continue to run, work out, and avoid eating most things that are white (Salt, sugar, starch-filled things, white bread, white pastas, creamy things etc).  I blogged about the weight loss here.

I will be back to regular blogging again soon.  Meanwhile, here is a picture of me on the far left in the black t-shirt with some friends at my Saturday event.  Next picture is with my wife enjoying the vineyards of Niagara region.

Cheers!

Hanging out with friends at the MS Fundraiser I did with my band Below the Belt. Thats me on the left in the black v-neck.

Enjoying time at a vineyard in Niagara Region with my lovely wife.

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.

Behind The Scenes with a Deafened Rock Star.


Ok, this title is wishful thinking.  Deafened, yes, but rock star, perhaps not.  We did a gig to raise money for a friend and colleague Warren Estabrooks whose organization is called “We Listen International”.  Warren and his team provide professional education, training and consultative services for professionals who work with children, teens and adults with hearing loss.

We started out the evening with some acoustic covers of some songs.  I played my acoustic bass whilst my buddy Dave played his 12 string and sang.  Later, my friend Maxine Armstrong, also an audiologist, did a beautiful rendition of Tom Petty’s Free Fallin.

My son’s Band Sticks and Stones were up next.  They played all original material that they wrote themselves.  Their sound is sort of “Indy” with jazz-like instrumentals.  Absolutely fantastic stuff.  If these guys had a recording contract, I am sure they would be hugely successful.  Check out their You Tube stuff here.  Also, you can download their songs here.

Finally, my bandmates and I got up to do about 18 songs.  I am so proud to be playing with these guys, everyone put in such a fantastic effort.  None of us are professional musicians, but we did our best to sound like it!

Speaking of professionals, special thanks to my good friend Ryan and his assistant Laura from Massive Tank Studios for doing the sound for the evening.  I love you guys!

Interestingly, while it is fun and exhilarating to perform music and have folks cheer for you, it is also quite stressful.  Why?  Because nothing ever goes exactly as planned.  The key is to not freak out, persevere, problem solve and find creative solutions. Lets take a behind the scenes look at the day to show you what I mean.

1 p.m.:  Start loading up the PA system, speakers, stands, bass amp, bass guitars, mics, cables etc etc.

2 p.m.: Start unloading gear at Pub.  First surprise.  Only one outlet box for all the gear.  Go and find more power bars and hope we don’t blow any fuses.

4:30.  Go to Music Studio to rehearse Free Fallin with Maxine.  Plan is to have two guitarist and one bass.

5:00.  Maxine still stuck in traffic.

5:15.  Rehearse with Maxine.

5:30.  Rush home to change.

6:00.  Go to Pub to finish setting up gear.  Three cables are dead, need to find replacements.  Deb, our singer needs a music stand.  Call wife to get her to bring one.  Forgot MyLink Receivers.  Call wife again to get those.

6:30.  My son has not arrived yet to do his set up and sound check.  He’s still at the tattoo parlor getting two new tattoos.  Really buddy?  On the day of the gig?  Is that a good idea?

7:00.  Supposed to start, but still setting up.  Someone has unplugged my TX300V FM from the Aux Out 1 and used it for something else.  I don’t think so people.  Deaf guy gets first dibs on sound.  Plus its my mixing board, so I get to call the shots.  Slightly tense conversations ensue, solution found.

7:40.  We start to do the acoustic set that was supposed to start 40 mins earlier.  First three songs are fine as we over-rehearsed these.  Maxine comes up to do her song.  Ryan was supposed to join us by playing guitar, but we ran out of inputs on the PA for another guitar.  Bummer, because while I love my buddy Dave who is playing guitar, he is rhythmically impaired.  Maxine sings like an angel, but I lose my timing.  Sound man Ryan sees I am struggling and becomes my human metronome.  I read his lips as he is counting out the time.  While I am playing some other folks with Cochlear Implants are requesting the MyLink FM receivers I promised.  Shit, they are still in my car.  Cant’ get them now, I am playing (for Pete’s sake!)

8:00.  Son’s band sets up to play.  No sound check because my philosophical artsy son decided to get tattoos earlier.  Their performance was fantastic, but the pub owners are complaining it is too loud.  Trying to get drummer to play as lightly as possible so everything else can be turned down.  All drummers are now unhappy.  I think all drummers were all born as Bam-Bam Rubble.

8:10.  I am using my son’s band as an opportunity to check my sound through the FM.  I discover the compressor is set wrong. Knee point is too low, compression ratio is too high and release time is too slow.

8:25:  Adjust compressor.  Hope its ok.  Run to car and get MyLink+ receivers. and hand them out.

8:30.  Start to play first set with my band.  Sound still not right.  Mouth to Ryan the sound man to increase vocals to Aux Out 1.  Reach behind me and increase knee point on compressor a bit.  Raise output on FM but over did it.  Sounds distorted.  It is peaking in the red too much.  Next song plan to lower it.  Can’t hear Luigi, the guitarist now.  Thankfully I know some basic chords on guitar, so I watch his hands to see what he is playing.  Luigi sees this, and moves a bit so I can see him play better.  He understands what I need.  I love you man.

8:35.  Discover I am not feeling the kick drum through my platform very well.  Look at mic on kick and discover its too far away.  Lower gain on FM.  Better.

8:40.  Move mic on kick closer, still not right.  But now I remember why…Warren, our drummer, is trying to play quietly (Quiet drummer…is that oxymoronic?).

9:10:  Finish first set, and take a small break.  Decide to play second set without my shoes on so I can feel the kick drum better.

9:25:  Start second set.  Sound is much better now.  I am feeling the kick drum on my platform through my shoeless feet  better now.  My timing improves.  Tweak the compressor a bit more.  Warren, the drummer, and I are communicating well via eye contact.  We are finishing our songs well.  If you pay attention to recorded songs, you will notice that they most pop songs don’t really end, but they are faded out by the recording engineer.  Live music requires a definite end, and getting everyone to finish a song at the same time is one of the challenges of playing live music.  We devoted an entire rehearsal to finishing songs!

9:50.  Sound is perfect now.  But that’s the last song.  Bummer.  We finally have everything perfect.

10:00:  Everyone is very kind with compliments.  Some of my brutally honest asshole “friends” also pay us compliments.  Hey, maybe we were good?  Actually, come to think of it, we were great.  Everyone loves our singer Deb, and they should.  She is a natural frontman (front-woman?) for a band.  I love you Deb!

10:15.  Tear down all equipment, load up cars, take equipment home.

11:30:  Go to Deb the singer’s house for drinks.

12:30 a.m.:  Son calls and says he needs to be picked up because his friends parents kicked everyone out of the house for being too rambunctious.  Hey, they are teenagers, what do you expect?

1:30 a.m.: Come home and unwind.

2:30 a.m.:  Go to bed.

Moral of the story.  Nothing ever goes as planned so don’t expect it.  Roll with it.

Captioning on In-Flight Entertainment.


Continental Airlines has Captioned Entertainment

I have been regularly zipping across Canada on airlines for about 15 years now.  In all these years, I have never been able to fully enjoy the in-flight entertainment as it is not captioned.  We have had captioning on television since the mid 1990’s, yet here we are in the year 2012 and in-flight entertainment is not captioned,

This is unacceptable and a human rights issue as far as I am concerned. People with hearing loss pay full fare for my tickets, and would like to have equal access.  We are not a small number…approximately 10% of the population has a hearing loss.  The noise levels of a plane would make listening to the in-flight entertainment challenging for pretty much all degrees of hearing loss.

I did some preliminary research on the internet to explore this issue and have learned that at least one airline, Continental, will provide captioned entertainment.  See this link for more information.  If one airline can do it, then they all can.

I plan on taking the following steps:

1. Start with a letter to both Air Canada and West Jet requesting captioning on in-flight entertainment.  I do not expect this will have much effect, but I am a firm believer in giving everyone a fair chance before going for more drastic measures.

2. If I do not receive a satisfactory reply from either of these two airlines within 30 days, I will next make a complaint to Ontario Human Rights Commission.  Specifically, there is the Ontario Human Rights Legal Support Centre that can assist in making a formal complaint to the Human Rights Tribunal of Ontario.

3. In addition, I plan to make a complaint to the Canadian Transportation Agency.  They have been mandated to make make transportation accessible to all persons with disabilities. Lets see what they can do.

4. I am not sure if the Canadian Radio-television and Telecommunications Commission (CRTC) has any jurisdiction here.  But I will also use their website complaint mechanism to see if they can help.

I will keep you all updated on my progress in this endeavor.  Wish me luck!

Hearing Not Required…


Shumka Dancers

I took my parents to see a Ukrainian Dance Troupe last night called “Shumka”.  This group based out of Edmonton Alberta (surprise, surprise) has been in existence for 50 years.  They put on an absolutely dazzling performance.  While my expertise on the art of dance is limited, I am certainly not ignorant to the elements of fine dance as I have been to about 10 ballets in my lifetime.  Last night’s performance, at least from my perspective, was every bit as technically sophisticated and beautiful as a ballet, but a heck of a lot more fun!

As I was watching and enjoying the performance, it dawned upon me that I was fully enjoying this event just like everyone else in the audience.  Sure, the dances were choreographed to music, but I heard that well enough. The music was not the focus of the performance, it was the dancers- their athleticism and ornate costumes.  I really did not need much hearing to enjoy this activity.  I just sat, clapped, and cheered like everyone else.

It seems that so many regularly occurring things in life are affected by hearing loss. Work, communication, enjoying television, theater, movies, music, going to a restaurant,  and going for drinks with friends, all require both technical assistive devices such as an FM system, and some accommodations from my family and friends in order for me to participate.  Not that I am complaining…I would not want to miss out on these important activities.  I am grateful that these devices grant me the necessary access and improve my ability to participate.

But its also nice to find exceptions to this through activities that are not taxing on the ears.  For me, these typically include hobbies such as fishing, archery, kayaking, hiking and photography.   And last night, it included dance!

Sometimes I wish I enjoyed more of the visual arts.  I have certainly tried…I have been to the Art Gallery of Ontario, the Musee du Louvre and Musee d’Orsay in Paris, the Met and MoMA in New York to name a few.  Sadly, visual art does not speak to me the same way that music does.  Perhaps I lack the training and education to fully appreciate the immensity of meaning these pieces of expression may hold.

In any event, there is much to enjoy in this world that does not require good hearing.  I find that it is quite beneficial to seek out these “hearing not required” activities to enrich our lives.  It also provides necessary relief from the challenges of hearing loss.  Its good for you!

For Family Day today, we are off to the Bell Lightbox (Home of the Toronto International Film Festival) to see a French film called Lancelot du Lac.  It will have English subtitles for all the viewers, not just me.  It should be fun!

Best and Worst Musical Instruments for People with Hearing Loss


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

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

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

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

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

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

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

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

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

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

Challenging Instruments to Play with Hearing Loss.

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

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

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.

Strategies for Communicating in Restaurants


Dining plays in an important role in many cultures.  I think we can all agree that we do not eat simply to nourish our bodies.  It is the human connection that seems to be the most important part of dining.  We propose marriage, celebrate birthdays and anniversaries, close business deals, and simply connect with friends and family while dining.

Unfortunately, many people with hearing loss cannot enjoy the social benefits of dining due to their reduced ability to communicate in this noisy environment.  Indeed, many simply accept that they will only be there to consume the food and not much else.  Others simply choose to eliminate this social activity from their lives altogether.  This is very sad.

There are solutions, however.  These will depend partly on your degree of hearing loss, and partly on how noisy the restaurant is.  In the chart below I list the possible solutions for the various environments for different hearing loss levels.  Note that I am assuming that you have a hearing aid.  The last line is suggestions for CI users.

Degree of Hearing Loss Cafe(SNR @ 5 – 0) Restaurant (SNR @ 0 to -5) Bar (SNR @-10) 
Mild Hearing Aid with Directional Microphones Hearing Aid with Directional Microphones FM system in Zoom
Moderate Hearing Aid with Directional Microphones Either FM system in Zoom or hearing aid directional mic FM system in Zoom.
Moderate-Severe Either FM system in Zoom or hearing aid directional mic FM System in Zoom FM system in SuperZoom
Severe FM system in Zoom FM system in Zoom or SuperZoom FM system in SuperZoom
Profound FM system in Zoom FM System in SuperZoom FM system in SuperZoom
Cochlear Implant Directional mic on CI or FM system in Zoom Directional mic on CI or FM system in Zoom FM system in SuperZoom

So what are these microphone positions I am referring to?  Well, on the SmartLink and ZoomLink there are three different microphones.  The Omni mic is at the bottom and it picks up sound in all directions.  I never use this position in a noisy restaurant.  The middle microphone is called the Zoom position.  This picks up sound from the front, but not from behind.  The top microphone is referred to as the SuperZoom position.  This is a beam forming microphone that only picks up sound directly in front, but not from the sides or behind.

The SuperZoom and the Zoom microphones are the most effective in noisy environments like a restaurant

The trick to getting the most out of your directional microphone or FM system is getting the correct seat. You want to have the noise that you don’t want to hear BEHIND you.  A lot of people make the mistake of getting a table in the corner and having the person with hearing loss sit in the corner facing the entire restaurant.  This is the WRONG seat.  You want the background noise in your back.  This way your directional microphones, either on the hearing aid or the FM system, cancel out this noise and only pick up the person in front.

So here are the steps I take when going our for dinner.

  1. Try to find restaurants that are already quieter.  Choose restaurants that don’t blast music during dinner.
  2. Ask for a table in a quiet section of the restaurant if possible.
  3. Seat yourself with your back towards the background noise.  The waiter will try to seat you in the corner with your back to the wall.  He means well, but ignore him and seat yourself correctly.
  4. If you are a small group, seat the other people in front of you.  Ideally you should see the people you wish to hear in front of you and that’s it.  This way your microphones are only picking up those you wish to hear.  I then place my FM system on the table about half a meter away from the people I want to hear.
  5. If you are a larger dinner party, this presents a challenge.  You will still seat yourself as I described.  But your microphones will not always be pointing at the person who is talking.  You need to move your microphone towards the person you wish to converse with.

A couple more points to consider.

  1. If I am having dinner with just one other person, I may get his person to wear the transmitter.  But I do so after the waiter finishes blabbing about all the specials and takes my order.  (Some of these waiters seem to love the sound of their own voice because they talk way too much.  Hint to waiters: Less talk and better service = bigger tip from me).
  2. The FM microphones work best when they are as close to the talker as possible.  So place the transmitter on the table no more than half a meter away.
  3. When the waiter brings the food, grab your microphone off the table, then reposition it.
  4. When having Sushi, keep the microphone away from your Soya Sauce.  I have killed a few transmitters from spills.
  5. In large dinner parties, you will still miss out on some conversation because the microphone is only pointing at one or two people at a time.  Yes, this is still a limitation.  But you can either sit at home and sulk, or you can still be partially engaged.

What’s Wrong With Saying “What?”


This post was inspired by a fellow blogger (http://chroniclebionicwoman.wordpress.com/2011/10/25/bionic-woman-on…faking-it/) who wrote about the perils of “faking it”.  It got me thinking of what we folks with hearing loss do when we don’t understand or hear.

Our initial inclination is the say “what?”, “huh?”, or “pardon me?”.  However, many moons ago, when I was in grad school for Audiology, I began to wonder if this was a good strategy to employ.  Or maybe we should try a more effective strategy.

When we fail to understand what has been said, we need to employ a request for clarification (RQCL).  RQCL can be classified into 2 categories; Specific RQCL and Nonspecific RQCL.  The chart below shows examples of the two different types.

Nonspecific RQCL Specific RQCL
What? What was that last part you said?
Huh? Can you please say that again more slowly?
Pardon me? Did you say you were going shopping?
Can you please repeat that? Can you please move your hand away from you mouth and repeat again?
I didn’t hear you, come again? Are you talking about baseball?

As you can see the Specific RQCL either asks the communication partner to repeat or rephrase only a portion of what was said.  Or it requests a change in the manner in which the utterance was spoken.  In either event, we are guiding the communication partner to a successful repair of the communication breakdown.

I had a theory that our communication partners would respond more favorably to Specific RQCL.  So I designed a series of experiments in which people had to rate how they felt about a person with hearing loss after watching a videotape of a conversation between a person with hearing loss and a normal hearing individual.  The conversations were scripted ahead of time to control for the number of communication breakdowns that occurred (Low, Medium, and High) as well as the type of repair strategy used (Nonspecific and Specific).  Subjects then used a semantic differential scale to make the ratings.  Below are just a few of the items from the scale I devised:

Talking to this person would make me feel…

Composed       1      2      3      4      5       6     Irritated

Energetic         1      2      3      4      5       6      Tired

Pleased            1      2      3      4      5       6      Annoyed

Comfortable    1      2      3      4      5       6      Uneasy

Here are the results from the study.  Note that a higher number indicates a more emotionally negative rating while a lower number indicates a more emotionally positive rating.  In other words, we want a lower number.

These results show a couple of things:

  1. When we have a low number of communication breakdowns (less than 25% of the exchanges), people have a more positive reaction to us.  It didn’t seem to matter if we only said “what”.  As long as we don’t do this too often, reactions will still be positive.
  2. When we have a medium or high level of communication breakdowns (greater than 50% of the exchanges), people start to get pissed off.
  3. If we use Specific RQCL, people react more favorably, especially as the number of breakdowns increased.

So what does this mean for us folks with hearing loss?

  1. It is crucial we get the best possible technology to help us hear and understand better so that we can reduce the number of communication breakdowns that occur.  That means having good working hearing aids or cochlear implants with directional microphones and, if needed, an FM system.
  2. Try to use Specific RQCL such as “Can you please repeat the last part”, “can you please slow down” etc.

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.