Activation, take two!

Yesterday was "activation" for my second Esteem.  It went really well!  I was super nervous because Megan (my MUCH loved audiologist) is no longer working with my surgeon.  I was really pleased with the new audiologist, though.  I was mostly nervous because there was a technician from Envoy (the company that makes the Esteem) at the appointment.  I had heard lots and lots of horror stories about the techs.  Several other implantees were really unhappy because the technicians would only set new activations with factory settings.  I knew I would NOT like that at all and really appreciated Megan's individualized approach.  Fortunately, I had a great experience!!  The programs are individualized and I felt like I was listened to.  My right Esteem (2nd one) has the exactly same settings as my left.  Being bilateral is really new for me because I've always had a 20 decibel difference in my ears.  It will be an adjustment, for sure!!

 My goal in writing this blog is multifold: First and foremost, I have an opportunity to let everyone know about this miracle that God has allowed me to experience.  I want to glorify Him!  The other main reason is that I was so grateful for other Esteem blogs before my first surgery.  It's a very new procedure and I don't know anyone else (in "real life") who has been implanted.  It's nice to read about other peoples' experiences.  For this reason, my mom took LOTS of pictures yesterday so I could show y'all what activation is like!  I realize a lot of you reading this are friends and family of mine (and I'm so very thankful for all your sweet encouragement through all of this!) and many of you have probably never had a full hearing test or seen any of this before.  Hopefully it's interesting and not boring! :)  The pictures are out of order because Blogger is not cooperating!

Bone conduction test:
I have (had?) sensorineural hearing loss, meaning that my hearing loss is caused by dead or improperly formed hair cell nerves in the cochlea.  The other type of hearing loss is bone conduction.  To test bone conduction, they put a little headpiece against the bones on the skull and transmit sound through it.  Obviously, this is kind of unpleasant when you have a relatively new implant in your skull! :)  You can't see the headpiece here but that's what the wires are for.  This is the first test they did yesterday because I had already turned the implant on.  At my first activation, Megan activated the device ASAP (or I might have gone insane!) :)

To transmit the new or updated programs to the implant, I have to hold the personal programmer (remote) against the implant.  In this picture, Arineh is updating the programs in my left (first) implant.

Because my implant site has been super tender this time, it HURT to hold the personal programmer against it for a long time.  The headband is supposed to keep it in place but it didn't work because my head still hurts!

Testing the device!!  The audiologist has to do some tests on the sensor and driver of the Esteem and find the maximum gains.  During these tests, I have to hold the remote against the implant.



Intense focus here.  Actually, it just hurt a lot and I was in pain, but focus sounds better, right? :)  (Arineh, I hope it's ok that I put this picture of you!)

Pure tone test (aka "beep test").  This is like a school screening test but much more thorough.  The audiologist plays beeps or warble tones at various frequencies (500, 750, 1000, 1500, 3000, 4000, 6000 and 8000 hz) and records the lowest decibel at which I can hear them.  The thing in my hand is what I press when I hear a sound.  The wire coming out of my ear is an earbud-type device that transmits the sound.  Now that I can hear in both ears, I have to turn off the implant that is not being tested.  I HATE THIS TEST!!!!!!!!!!!!!!!  Any of you who know me realize I am VERY analytical and I HATE to fail at anything so, of course, I hate hearing tests.  The first few beeps are okay but then I imagine beeps because I know I *should* be hearing them.  It's stressful...seriously.  I hear beeps for hours afterward. :) This is also when the audiologists tests for Speech Reception Threshold (SRT) and Word Recognition/Speech Discrimination.  For SRT, the audiologist reads a list of two-syllable words (airplane, cowboy, hot dog, sidewalk) and gradually reduces the sound until I can't understand it anymore.  For Word Rec, they play this obnoxious CD of a man with an annoying voice saying, "Say the word_____" and a bunch of one-syllable words.  One syllable words are a deaf person's worst nightmare!  We usually miss out on beginning and/or ending sounds of them.  For instance, dark/darn (that's one I missed back in August).  The vowel sound stands out in words but those consonants are tricky!

On the way to the appointment, we stopped at Target in Lakewood.  Actually, I found it without navigation or directions...amazing.  Anyhow, I wanted to get a headband because they didn't have one at my first activation.  Unfortunately, the pink one wasn't tight enough to hold the remote against the implant. :(

The actual testing takes place in a soundproof booth, which you can kinda see through the glass.  I sit in there and the audiologist sits in front of the computer.  The headpiece over the computer is for the audiologist, so she can hear me and talk to me during the test.  The computer on the right is specifically for the Esteem.

Two remotes!

After I took the headband off :)  My mom loved this picture.

Great results!  The column on the left is with my Esteem, middle is baseline and right is with a hearing aid (all my right ear).  SRT of 25 dB or lower is normal...so I'm pretty darn close.  I find it hilarious that my uncomfortable level with the Esteem is LESS than my MOST comfortable level before. :)  The discrimination in quiet scores are that annoying "say the word____" test.  Normal conversation is approximately 50 dB.  At that level, I understood 80% of words.  With a hearing aid, I only got 60%.  I do not have test results at that level with no amplification but it would have been bad. :)  At 85 dB (which is VERY loud, a little louder than a piano), I got 96% of words with no amplification.  That's painful with the Esteem. :)  At 70 dB, with a hearing aid I got 96% of words and with the Esteem, 100%.  With my first Esteem, my speech discrimination scores improved over time, as I learned how to understand words through the Esteem.  It will probably do that again.

This is an audiogram.  The Os are my hearing before surgery with no hearing aid.  The E's are with the Esteem.  The X-axis (horizontal) is frequency (which correlates with pitch).  The Y axis is decibel (volume).  Anything 25 dB or lower (0-25, which is higher on the graph) is normal.   It does not show much improvement at the lower frequencies (250, 500, 1K) because my ear is still full of fluid.  If there's fluid in the ear, it's kind of like being underwater or at high elevation.  Once it's healed, I will see improvement in those frequencies.  The gray blob shows where most speech sounds lie.  Right now, there's not much improvement over my hearing aid on this test, but this was my "good" ear.  I had decent hearing with a hearing aid in this ear when it was tested in a sound booth.  Unfortunately, there's no test to measure quality! :)  I'll have to do another post about that soon!