Tag: amplification

The First Time I Resented My Hearing Aids [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

It was last week. I guess a two-year love story with my aids is not too bad, so it had to happen someday.

Playground

I was working in my office when a loud alarm-like sound went off. Now, in certain parts of the world this is habitual, but not in this quiet little part of Switzerland. We don’t have house and car alarms going off twenty times a day (we don’t have house or car alarms most of the time). Ambulances and police cars sometimes go by but they won’t use their sirens unless they need them.

We looked at each other in the office, and I hopped out of the ground-level window to investigate. Was this going to involve calling the police?

The noise actually seemed to be coming from the playground, and not the parking lot next to it as I had thought initially. By the time I was close enough it had stopped. I checked out the playground and saw a couple of little kids putting down huge plastic sci-fi guns down. Now that was more plausible than a rogue car alarm: noisy toys. I wandered around the garden a little, searching for one of my cats, when the sound went off again. This time it was clearly coming from the playground, and I could see the kids in full action with their guns, shooting at imaginary hostiles in the bushes.

I made for the playground, called to the kids, and told them off for making so much horrible noise when there were people trying to work or rest in the neighbourhood. We like our peace and quiet here in the land of the Swiss. They looked at each other, at me, shrugged it off, and as I turned to go, I heard a woman calling to me from the balcony three floors above. They were her kids, and she was quite angry at me for telling them off when they were just playing in the playground on a sunny vacation day.

I told her that yes, I had asked them to stop that horrible noise because it was really unpleasant. She went off in a big rant about letting kids play and that I just had to live with it. I told her again that the noise was really bad, and that I was wondering what was going on because it was so loud and sounded so much like an alarm. She wasn’t really listening to me, though, and just ranted back.

That’s when one of the men in the park jumped into the conversation and said it was a car alarm. And I said yes, it sounds like a car alarm, don’t you agree it’s a bit disruptive for “kid’s play”? But he insisted. It was really a car alarm. It wasn’t their toys.

As soon as I realised what a terrible mistake I had made, I immediately apologised profusely, to the mother, and also to the two boys, with whom I double-checked that it wasn’t their guns. They seemed to get it.

The mother didn’t, however. She continued ranting at me even though I was now trying to explain that it was a misunderstanding and I was mortified about having told off the kids who were doing nothing wrong. And of course I would never have told off kids for playing in the park, I only did so because I thought their guns were making this horrible loud noise. I couldn’t get a word in, and I’m usually pretty good at that.

At one point I understood she had no clue which noise I was talking about, and so when the alarm went off again, I pointed it out to her. She clearly thought I was crazy for imagining this noise could come out of a child’s toy and scoffed at my explanation. I wonder now if she thought I was trying to make up an excuse because she had “caught me” telling off the kids for playing?

And then it dawned on me. One piece of information she was missing was my hearing loss and hearing aids. So I tried to tell her. I said “I’m sorry, I’m hard of hearing and sometimes I have trouble judging the volume of noises and where they come from.” The ranting didn’t stop, and as by that point I was bursting into tears, I ended up walking off.

Now, there were a bunch of upsetting elements and triggers in this episode for me. I was stressed, preoccupied about something unrelated, and being falsely accused of something (like hating children and not wanting them to enjoy their spring holiday) is one of my big triggers. But what particularly upset me here is that I would never have got myself into this situation if I didn’t have hearing loss and hearing aids.

My world of sound is not imaginable for the angry ranting mother on her balcony. My hearing aids are wonderful when it comes to communicating with people, but two years in (and maybe my fault for not wearing them from morning to evening even when I’m alone?) there are still some ambient sounds which startle me and register as “unknown” because they’re just not at a volume I expect. And despite all the wireless and electronic magic going on in my hearing aids, I do get the feeling that for certain sounds, I have more trouble than I used to identifying their origin.

My hearing loss has long felt like a detail in my life. These last years, particularly since my fitting, have been a journey in realising how much a core part of who I am and how I relate to others has its roots in how much — or little — I hear. I’m used to having one-way communication with children I don’t know, because without hearing aids, I can’t understand a quarter of what they say (and children are not good at all at dealing with an adult who asks them to repeat stuff). Had I approached those boys to talk with them and make sure their guns were making the noise I suspected, things would have been different. But I didn’t, because I’ve learned not to start conversations or ask questions when I’m not going to be able to understand the answer. Had I not been muddled about volume and orientation of the sound I heard, because I can still be surprised at how unexpectedly loud certain sounds can be, I wouldn’t even have suspected the kids for starters. I thought the noise sounded loud to me because I was wearing my hearing aids, not because it actually was that loud.

It hurts to realise that my ears (organic and electronic) can lure me into such socially disastrous situations.

After I’d calmed down a bit, I went back to the playground and approached the kids. I wanted to make extra sure they had understood what the misunderstanding had been, and heard how sorry I was to have wrongly told them off. They had! 🙂

More About Hearing Aids (And Geeking Out a Bit) [en]

[fr] Des nouvelles de mes aventures au pays des appareils auditifs: réflexions pour geeks et moins geeks, tant l'expérience humaine que la technologique sont passionnantes!

I got my hearing aids a month and a half ago, and I thought I’d write a bit more about some of the techy aspects as well as what it means to (a) be wearing hearing aids and (b) be hearing better.

Past the initial shock of “OMG do people really hear sounds this loud?!”, I’m really appreciating how relaxing it is to understand pretty much every word people say to me. Even in “good/easy” situations, I realize how much of my hearing is actually “deducing” — specially on the rare occasions nowadays when I talk to people without ma aids in.

As my brother aptly put it when we compared notes as I was coming out of the audiologist’s, it’s “as if sound were coming to me, rather than having to go and fetch the sound”.

Physically, my hearing aids are really comfy now, and I am generally not aware that I’m wearing them. Like a pair of glasses (or a bra!) — you know they’re there if you think of it, but they’re not drawing your attention to them all the time.

The model I’m trying now (I’ll be moving on to my second trial when I get back from holiday, more about that below) is the Widex Clear220 C2-PA (here’s the Widex product page, but it’s not nicely linkable, you’ll have to click around to see the once I have). It’s a mini-BTE (“behind the ear”) with the receiver in the canal (RIC). I’m still learning the terminology, and I have to say “receiver” sounds like a very illogical word for what is in fact the “loundspeaker”.

There are two microphones on the top of the piece that lies behind the ear. My audiologist told me that in noisy environments, the second one kicks in and the aid then reduces the sound coming from the sides and back to focus mainly on what comes in from the front microphone (theoretically: the person I’m speaking with).

The two hearing aids also communicate wirelessly with each other, and do fancy stuff to help with sound spatialisation (ears do fancy stuff too, but with RIC the hearing aid is sticking sound directly in your ear canal, so it needs to mimic what your ear does to sound before that).

The aids also clip loud sounds so that they don’t go above (a) potentially damaging volume (b) the volume above which sound becomes uncomfortable for me (I think).

2012-05-05-IMG_2910.jpg

If you look at the line around 80-100dB, that’s where my discomfort to sound is. It’s quite common that people with hearing loss also have a low tolerance to noise. That means there is less “bandwidth” for the audiologist to work with.

Oh, and you know one of the things associated with hearing aids? The Larsen effect? You don’t really get that with digital hearing aids, because they’re programmed to detect that kind of sound and remove it.

So, what about the less exciting stuff? Well, I was lucky enough to have a car on loan during the first weeks I had my aids. That gave me a chance to test their reaction to loud singing (!) at different frequencies ;-).

Here’s where it gets interesting: my left hearing aid (in theory the one with slightly less amplification) would clip or chirp at certain frequencies (understand: me singing at the top of my voice as high as I can go — only in the car, people). It’s annoying enough to hear sound that seems to be coming out of a saturated loudspeaker, but when it’s only in one ear, it’s quite maddening.

Other than that, during my first few weeks of test, I had one or two occurrences of chirping. Chirp! You’re walking around in town, and suddenly one of your ears chirp. It happens so fast it leaves you wondering if you dreamed or if it really happened. I’ve actually managed to produce some frequencies (in the car, not reproducible elsewhere ;-)) that reasonably reliably make it chirp, but other than that I’ve had trouble reproducing the problem.

Early on, another problem I had was that I had the impression my left hearing aid wasn’t amplifying some frequencies. The symptom was I felt as if I had a blocked ear, or cotton in my ear — but it was very mild. It felt as if the receiver was maybe not in the right place (but it was, my audiologist checked). So we did a few tests, and during one of those, one of the frequencies we tried sent the aid into a long continuous beep that didn’t stop until we opened the battery casing to turn it off. I had to pull it out of my ear, and my audiologist was able to witness the sound himself (he has a stethoscope with a special attachment that allows him to listen to what is coming out of a hearing aid). Bug, he said! That hearing aid will be going back to the manufacturer at some point…

We never did completely pinpoint what it was that caused this “muffled” sound, but spatial orientation tests showed that I was slightly disoriented towards the left. So we boosted the right ear by 1dB (counterintuitive… but oh well, audiology is an experimental science). I suspect that the “muffled” feeling could in fact be due to the pressure of the tip in my ear (my left canal is smaller than the right) or something like that. Later on, I discovered that the top of the BTE casing was a tiny bit loose, and we changed it. Right now I have to say I feel this “muffled” problem has completely gone away. Either I got used to it, or something we did made it go… Don’t know.

A couple of weeks back I got an extra 2dB (I started at -8dB, and my audiologist usually starts people at -4dB). It was loud, but bearable. However, the clipping got worse, and worse than that, I found myself having trouble understanding people in situations where it seemed to me I should not be having so much trouble. Restaurants, hallways, noisy places. Back in the office, we actually tested this: word recognition in noisy environments. And the verdict seems to confirm my experience: I understand more words with less amplification. One more reason to try another hearing aid before making any final decision.

I walked out of the office with an extra toy: the M-DEX. The M-DEX does a bunch of things:

  • it connects to your phone by bluetooth and allows your hearing aids to function like a bluetooth headset, streaming sound directly into your aids
  • it’s a remote for the hearing aids (sound up, down, left, right, zoom, mute, music/voice programmes).

M-DEX

As far as I’m concerned, the phone bit (what makes it so expensive) is a complete fail. Pairing with the phone is not a problem, and I manage to get sound into my hearing aids, but the sound quality is much much worse than if I simply put the phone to my ear or stick in my earbuds. This reminds me to mention that I can actually fit my earbuds in my earn “over” the hearing aids. They’re a bit loose and fall out easier, and the sound doesn’t really get amplified by the hearing aid, but it works. For the moment my preferred option is still “earbuds and no hearing-aid” for the phone.

I tried with music rather than phone, and I have the same problem: a huge amount of static background noise, and volume so low that even at maximum setting I have trouble recognizing the song that is playing.

The M-DEX comes with a jack cable, so I tried connecting my phone to it with the cable rather than bluetooth. There is much less static, the sound is much better, but it’s still not really loud enough or clear enough to be an interesting alternative to simply wearing the earbuds, even over the hearing aids.

I have to say I’m pretty disappointed about this bit: I use the phone quite regularly, and listen to a lot of music and podcasts. I can’t believe there isn’t a simple “equalizer” software or application for my phone which I could feed my audiogram to and which would then amplify the frequencies I need. Clearly it wouldn’t be as good as a proper hearing aid, but I’m sure it would help a bit. If you know more about why this isn’t done, I’m all ears (!).

One thing I’m really happy with, though, is the remote function of the M-DEX. Given the problems described above in noisy places, it really helps to be able to bring amplification down a notch (both for troubleshooting and better hearing). I’ve toyed about with the zoom function a bit (selectively amplify sound from behind, left, right, in front) but for the moment I haven’t found a real use for it. Same for selectively amplifying left/right ear.

I absolutely love the “mute” button. Even though I’m trying to wear my aids as much as possible to train my brain to adapt to my new sound environment, it’s quite a relief to be able to just switch them off when it gets too noisy, or when I want to concentrate on something (reading on the train, working in the office), without having to physically remove the hearing aids.

One other annoying thing about the M-DEX (this is a comment I saw somewhere, can’t remember where) is this idea that the M-DEX is going to be the device you interact with rather than your phone. You can dial from it, pick up calls, hang up. Well, OK, maybe this makes sense for technology-confused people, but as far as I’m concerned I’d rather have, as the author of that same comment suggested, an app on my iPhone to control my M-DEX. Leave it to phone manufacturers (or Apple) to make phones.

Leaving aside the tech, one of the effects of wearing hearing aids is that I hear my tinnitus more. Luckily, it’s not bothersome: “white noise” type, not too loud, and not an annoying sound to me. It’s a normal phenomenon: while wearing hearing aids, I’m training my brain to tune out other ambient sounds which are louder than I’m used to, and as everything is louder, my brain doesn’t spend the whole day tuning out my tinnitus so I can hear stuff. It’s relaxing, but it means I’m “out of practice” tuning out the tinnitus, so I hear it more when I remove the hearing aids. No biggie, but I thought I’d mention it, because it’s an interesting phenomenon.

And as far as sharing online goes, I stumbled upon the Hearing Aid Forums — a lively online community of hearing aid users and professionals.

So, where am I, overall? I’m now pretty much “habituated” to hearing better (still -6dB from my “ideal” settings), and if you give me the choice between giving back my hearing aids and keeping them, with the glitches, I am definitely keeping them. But maybe the next trial will give me something even better!