Cochlear implant

MY COCHLEAR IMPLANT: THE 3-MONTH AUDIOLOGY EVALUATION – Garry Armstrong

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LEARNING TO HEAR by Garry Armstrong, 
Photography: Marilyn Armstrong

Sing “Hallelujah” softly and this year, I will hear you. Crystal clear!

One of many hearing tests

That’s the lead on a delightfully mild Monday as I look back on today’s evaluation of my Cochlear Implant at UMass Memorial Hospital.

It was like getting an A on your first major exam in college.

Nicole Seymour, audiologist on the job!

Last week, I got excellent grades at the surgical evaluation of the Cochlear procedure. All the stuff placed inside my brain was line-dancing with the receiver parts atop my head and right ear. No unseemly scars, bumps or rashes. Even my fast receding hairline appears to be flourishing.

Is this a side perk?

Garry in the booth, listening to the test signals

Today was a detailed session of testing and adjustments. I sat in a small room that looks like Interrogation Room 1 on NCIS, but with more electronic equipment. I went through a series of tests administered by my audiologist. The tests involved various levels of single-word recognition, complete sentence awareness, and range of tone comprehension.

It’s harder than you think.

Putting the equipment on again

If you’re hearing-challenged, which is to say, deaf, you have problems with all these things. Single words that rhyme – led, dead, bread, red are easily confused. Whole sentences are often misinterpreted, sometimes leading to misunderstanding and embarrassment. High and low tones aren’t audible. I couldn’t tell the difference, so statements and questions sounded the same.

Consultation

I sat tensely – my body coiled – as I sat for decades during my TV news career. Struggling with interviews, courtroom testimonies, and pivotal political speeches. My breath came in rushes because I wanted to be successful.  A lot rides on the cochlear implant. At age 76, this is a major turning point. 

I can experience clear hearing for the first time in my life.

I clearly heard many of the words, sentences, and sounds.  But some of it was guesswork, just as it was throughout my working years. I could feel my body tighten as I wondered how well I was doing.

Nicole setting the levels on the implant headset

Progress or not?  I’ve been working hard with the cochlear implant. I wanted progress very badly.

Tools of the trade

When it came time for evaluation, the audiologist gave no facial hints. I was tense and nervous. She slowly and clearly told Marilyn and me that my progress was substantial with major improvements in all the areas tested. Some of the improvement was huge, some more moderate. But everything was better.

I smiled inwardly which turned into a broad smile that could have lit the room.

Filling in the forms

My cochlear implant and the hearing aid in my left ear were adjusted to give me more audio on 5 levels. She expected I would probably not want (or need) the strongest (loudest) level, but it was there, just in case. The new “bottom” level was the top of my previous levels. Go, Garry!

Setting the new levels on gear

In the coming weeks and months, Marilyn and I will be attending several large events where there will be many people, lots of background noise including live music — the dread of anyone who has trouble dealing with background noise. These events will be powerful tests for my implant.

More tests

What’s more, these are exactly the events that I dreaded before the cochlear implant surgery.

Now, I am eagerly looking forward to them.

Hallelujah! Time to celebrate!

ANOTHER DAY AT UMASS – Marilyn Armstrong

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It’s another one of those lost days for us. This is Garry’s official 3-month audiological checkup. I’m expecting great things.  I’m charging my little camera because this time, I am remembering my own excellent advice:

NEVER GO ANYWHERE WITHOUT A CAMERA

my camera because even though it makes the bag more than a little bit heavy, you just never know. Pictures just happen.

I am due for at least one smiling photograph of Garry and his audiologist.

I’ll tell you all about it, but today, I’m going to be missing in action.

Sorry. I don’t think we get a normal week until sometime in January! And then, I’ve got a book competition to judge. Maybe in February?

DOCTOR AND PATIENT – Marilyn Armstrong

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Today was Garry’s 3-month post-operative surgical appointment at UMass hospital.

He hasn’t had any problems at all with the surgery. Actually, he has not had any trouble with the process, except for the minor detail that every day is a surprise. Each new sound is something he has to recognize, then classify.

He hears the squeaky ball that Duke is chewing. He hears the trucks pulling into the driveway. He recognizes the opening and closing of the gate downstairs. He can hear his own breathing and finds it distracting. We all assure him he will learn to filter that kind of sound, as well as many other ordinary sounds that the rest of us automatically don’t notice.

It takes a lot of work to learn to hear when you are 76. Sounds that the rest of us have always recognized, he is hearing for the first time. It’s a lot of work and a lot of mental processing.

Garry and Dr. Remenschneider. When your doctor is not much older than your grandchild, you know you’ve put on a few years.

It can be a bit exhausting for him. I suspect sometimes all he wants is that old familiar silence where no one expects him to answer because they know he didn’t hear them.

Today he picked up the phone when it rang … and he heard it. He hates telephones and has for a very long time. It has a lot to do with getting calls from work at all hours of the day and night. Over the years it became a bit of a phobia. Hopefully, he will get over it. Because all of us deserve to have to listen to the other electric company’s spiel on how they will lower our rates (no they won’t). At least the political season is over for a couple of months so the surveyors won’t be calling. That’s something.

Dr. Aaron Remenschneider – and a great surgeon!

On the positive side, I am (finally) not the only one who wonders what that weird noise is in the basement. Also, when we have an argument, he knows what I said — which is not always ideal.

He is not the only one who has to learn new things. I have lost my role as permanent interpreter, which to be fair, I’m glad to lose. I have not lost my role in telling people to please speak up, especially the receptionists in the Hearing Clinic.

They speak so softly, I can barely hear them. Meanwhile, the people they are talking to are actually in the process of trying to learn to hear. I figure they should speak up. Put a little diaphragmatic air into your larynx and push it out through your vocal cords. That’s what makes it possible for others else to hear you.

It’s what speakers are taught. Actors and reporters, too. Sometimes, you don’t have a microphone. You just have you.

Okay, among other things, I was a speech major. Actually, I have a degree in it. I have never used the degree for anything except telling other people to “please speak up!”

Doctor and patient. Hint: the doctor is wearing white.

Garry is quite the star of the Otolaryngology Department. He can hear remarkably well for just three months into the program.

I expected him to be a star. When Garry works at something, he really works at it. He had to learn to speak properly with significant deafness. He learned it well enough to be on television every day for many years. So given this challenge, I knew he’d work at it as hard as he has ever worked at anything else in his life.

The hard work paid off. He can hear. I wish he had this option in his life many years earlier but if ever the expression “better late than never” had relevance, now is that moment.

Next week, he has his three-month audiological checkup. I bet he’s going to be a star.

HEARING, IMPLANTS — AND WHAT’S THAT SOUND? – Marilyn Armstrong

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A couple of days ago, Garry had his one-month follow-up for his cochlear implant.

It’s hard to believe it’s just one month since the gear went on his head for the first time and it’s also hard to believe how much change there has been in his ability to hear in just one month.

I wish I had numbers of the actual percentage of change for each type of sound. Some of them were really shockingly good. My favorite was his ability to understand a complete phrase — something with context rather than a single word without context which went from zero — nothing — to 76%. That was the gigantic jump. It gave me goosebumps.

Individual words — no context — was closer to 50% (from zero). The hard one — the one which is always going to be a problem — was hearing what someone said when there is background noise, the kind you hear in a restaurant where a lot of people are talking. That was up to 20% from zero. I’m not sure if that will ever “top the charts” since as we get older — and by this I mean a collective “we” — our ability to hear one voice above many other sounds will diminish.

I won’t go to a restaurant where they constantly play music. I never liked it even when I was younger because it made conversation difficult. Since “going out to dinner” is one of the most common ways people get to know each other, why make it so much harder to hear the other person speaking? And this was when I had normal (if not slightly better than normal) hearing.

These days, I don’t hear as well as I did a few years back. I sometimes miss the beep from kitchen timers, and when the three dogs are barking, I can’t hear anything. I dislike noisy restaurants and live music when I’m out to eat will make me run from the room with my hands over my ears.

I suspect the music (especially loud music) played in restaurants is more to keep the staff moving than for the benefit of customers. I’m here to point out that it drives customers away.

I have a weird feeling that eventually, Garry with all his electronic gear in place will hear better than me.

Won’t that be an interesting turn of events!

Meanwhile, Garry can — in a quiet room — have a pretty normal conversation with a small group of people. How he will do at a party or in a large group? Or anyplace with nonstop background noise and music? Probably not so well. Otherwise, though, he can hear. The rain on the roof. The rush of a waterfall in the distance. The buzz of the washer and dryer in the basement and he can tell the difference between the washer (loud) and the dryer (soft).

He can hear the lyrics to songs assuming the lyrics are audible. He can watch TV with regular sound, not headphones — and is discovering that just because you are paid a lot to be a sportscaster doesn’t mean you don’t mumble.

It’s good news all the way around. He is doing as well as expected in most areas and better than most in several. Listening is more like work for Garry than for me. He has to try harder to catch the sounds, but the more he works at it, the better he gets.

But please, don’t everybody talk at once!

BRACE YOURSELF! GONNA BE A LONG DAY – Marilyn Armstrong

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RDP THURSDAY – BRACE

It’s going to be a long day. Any time we have to get up early for one of these extended audiological checkups for Garry’s cochlear implant, it’s going to take a while. This is the one-month followup and I believe it will all be good news.

I also am pretty sure he needs a tune-up, especially for his left (the non-cochlear) ear because — how ironic! — that’s the one through which he hears much less than in the “new, rebuilt” ear.

We didn’t get that “sudden” moment when he just says “Oh, wow, I can hear.” More like realizing that he can hear the rain on the roof — and it’s loud! He didn’t know rain could be so loud. Or hear the beep from the microwave in the kitchen, the funny scrunchy noise you hear when The Duke has found something hard and plastic to chew on. The buzz the washer and dryer give from the basement and realizing he can tell the difference between the loud buzz (washer) and softer buzz (dryer).

How LOUD the dogs really are! And that he still won’t answer the telephone or even try. He hates the phone and I don’t think he will ever entirely recover because he hated them even when he could hear on one.

Finally, having an actual conversation with a total stranger in the grocery store when normally, he’d not even have heard her say “hello,” much less indulged in a conversation about whether or not it’s possible to not have failed to mention a sexual assault for 36 years. His answer being, “Absolutely. I remember how terrified those women were when I tried to talk to them.” Because he covered a lot of domestic violence calls and the story was always the same — women terrified, men hostile.

Our police chief told us that the most dangerous calls they make are for domestic violence. Those are the ones where a cop is most likely to be injured and also the cases that will never go to court, nor justice be done.

And me thinking there were things I’d never told Garry yet because all it would do it upset him and there was no reason dredge up old misery. Women don’t tell their men things. We don’t want to upset them if there’s nothing to be done to fix it — and they get extremely, sometimes lethally upset. Who needs that?

Having a reasonably normal conversation with a friend … and not having to say “what” a dozen times.

Discovering he can still take off his new hearing aids, put back the headphones and ignore me for a joyful few hours. Drat. I should never have pointed out he could do that!

It will be a long day and Garry’s not feeling well. Tomorrow we go for blood tests and find out what — if anything other than hay fever and age — is the problem. So let’s brace ourselves for two long days!

UPDATE: WEEK 2 – ACTIVATED COCHLEAR IMPLANT – Garry Armstrong

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I feel like I should be singing “Getting To Know You” as I write this update.

It’s the beginning of the second week, wearing my activated cochlear implant.  It’s Saturday,  the first day of the 9th month.  If you sing “September Song”, I could probably hear most of the lyrics.   Maybe I’ll listen to Walter Houston’s memorable rendition of that melancholy song later today.

September is usually special because we celebrate our Wedding Anniversary and granddaughter Kaitlin’s birthday along with keeping eyes (and now ears) on our Boston Red Sox, hoping they can finish their 6-month marathon with a pennant championship en route to the World Series.

This September Sabbath began on a down note.  Blame it on the weather.  I’d planned on taking in a town event, “Uxbridge Day”, which figured to give my cochlear implant a public test,  mingling with dozens of people on our town square. Between the hot weather, an Excedrin Plus headache, and general fatigue from this long week prompted me to cancel plans.

We’ll hold off on the cochlear implant public début for a while.

Yesterday,  I received my first evaluation on the cochlear surgery and performance of the week-old activated parts. Marilyn and I shared our response to how I fared during the first week of my new hearing.

They were mixed reviews.  The audiologist did some tweaking, essentially giving me more volume. Now, I’m hearing louder bells, whistles, chimes, echoes and other “ghosts noises.”  I’m told these noises will fade in 3-months to a year as I adjust to this new way of hearing.

I’m from Missouri.  I’ll believe it when it happens.

Marilyn and I have discussed how we communicate with each other. This is a bonus because people with normal hearing have similar problems but rarely discuss it for fear of marital discord.  Who’s at fault? No one.

I feel as if I should be singing “Getting To Know You.” No, I don’t feel like Yul Brynner, King of Siam. I’m becoming more comfortable with my cochlear implant exterior parts. It’s somewhat awkward for me connecting the battery to the transmitter which sits atop my head and sends signals to “base headquarters” inside my head.

Usually, I need Marilyn’s help.  Today, I did it MYSELF!  Hallelujah!  It felt so good. I patted myself on the head, careful not to dislodge the transmitter.  Marilyn cut out a piece of my hair so it would be easier to find a landing spot, making it easier for the magnets inside the transmitter to secure a spot on my head.  Like a spaceship landing on Mars.

As I write, I’m getting mostly “ghost chimes” in my brain and ear. It’s peaceful.  The dogs are not barking. The TV is in repose.  All is calm.

So far, so good.

FIRST DAY: ACTIVATING THE COCHLEAR IMPLANT – Garry Armstrong

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After 76 years, 4 months and 18 days of hearing impairment, aka deafness, I can HEAR in both ears. Sing Hallelujah. But hold the applause. We’re not home yet.

Right ear. This is where all the sound data is collected to be transmitted to the implant and then, the brain

I’m going to need a trim to my hair soon. It’s not easy finding my head and the magnets

I’m writing the morning after the cochlear implant parts were activated in my head. During activation,  I felt a little like “the creature” in “Young Frankenstein”.   We had a prelude where the audiologist carefully explained how to assemble the cochlear “accessories,”  how to place them on my head and in my ears. Marilyn was watching closely. Good thing because I was quietly panicking. I’ve never been good doing the simplest of assemblies. I’m very clumsy.

I was as anxious as a Red Sox mid-inning reliever.

After the tutorial, several dry runs, and increasing anxiety, all the parts were in place and activated.  All this came after lengthy audio tests to determine how loud my new ears should be.

I braced myself with everything in place.

The cochlear parts are for my right ear, the “bad ear” which gives me very little audio. I have a new hearing aid in my left ear, the “good ear” which is supposed to enhance the cochlear parts.

I’ll give you in my rookie wearer understanding. The devices you see entwined around my right ear collect audio signals and send them to a “transmitter” which, with magnets, sits on the side of my head. The transmitter sends those signals into my head,  to the “implant” which was inserted via surgery.  Okay so far?  Oh, and there are magnets in my head so the headpiece will stay in place. Magnets. In my head.

So far, so good.

I breathed loudly as everything was activated. The voices of Marilyn and the audio technician were very tinny.  I could hear Marilyn’s voice more clearly. She had more “body” in her words than the technician, who I could also hear clearly, but she has a thin, rather reedy voice. I tried to relax my body and let myself really hear what was being said.

Left side with the new hearing aid. Smaller than the old one. This part of the gear needs some work

Relaxation is key. All my life, I’ve physically strained to hear. Leaned forward to catch what people were saying.  It’s difficult and physically exhausting.

It’s been my norm for 76 years. Now, I had to try and change that life-long habit. I sat with my back to Marilyn and the technician to test how well I could hear without seeing the people talking and read their lips as I usually do.

Usually, I can’t hear Marilyn if I am not directly facing her. It’s produced years of frustration for both of us. I could hear, my back turned away, both Marilyn and the audiologist. (Insert applause here.)

Sort of “normal” Garry from the front. The backpack came with all the “stuff” packed into it including the implant gear, a backup set of that gear, all those tiny little tools you need for working with hearing aids, charger, a whole set of “foreign” plugs for when (ahem) we travel to far off places … and a drying to get the humidity out of the unit. A GREAT idea!

Still, the voices were tinny and they echoed. As I responded to questions,  my voice sounded clear, full of that crispness and authority that’s familiar to TV News viewers. (Insert laughter here). That my own voice sounded perfectly normal is a good sign. It means that my brain is recognizing my voice and turning it into “normal” sounds. Probably Marilyn’s voice will be next. Familiar voices become “normal” much faster than the rest of the world and some may never sound entirely normal.

I allowed myself a brief smile of satisfaction.  It was very brief because I was also hearing bells and whistles, like a train was approaching the station. It was bizarre. The audiologist nodded as I explained what I was hearing.

She said it was normal. That I probably would hear those noises for “some time” as I wore the cochlear parts in various situations. Reporter Garry wanted a time frame.  How long? No easy answer, but she said — in round figures — about three months.

We went over how I should adjust to using my new ears and the various parts, inside and outside of my head. My brain was swirling but, fortunately, Marilyn was absorbing the information. We made an appointment for an evaluation.  I thought a week might be too quick but now I’m glad because I have lots of questions.

During the drive home yesterday, I was able to talk to Marilyn with minimal “what’s?”   Call it an early triumph.

We were greeted by the boisterous barking of our three dogs.  Yes, they were very loud.  Their yaps and growls were “enhanced” with echoes.

As we crashed, relaxed, and wolfed down late lunch sandwiches, I flipped on the television to baseball. The announcers sounded tinny with accompanying echoes. Their commentary was hard to understand. They were blasted by the crowd cheers.

I lowered the TV volume and things improved.  But I still heard echoes, bells, and whistles and the occasional chime mixed in with everything else.  Marilyn talking. Dogs barking.

I tried to mentally adjust. Slow down my intake of what Marilyn was saying.

That helped.  I’m so used to responding without really hearing. It’s a whole new ball game. As late afternoon turned into evening, I became more comfortable but I could not get rid of the echoes, bells and whistles.  Sometimes it also sounded like church bells tolling. For whom were they tolling?

There was one constant amid all the extra sounds. I could hear Marilyn’s words — not just muffled sounds.  Yes, there were a few “what did you say” moments, but a small number compared to life before the cochlear implant activation.

Marilyn took care of unloading my new backpack, filled with all the cochlear accessories, manuals, batteries.  She setup the battery charges and patiently walked me through everything.  Frankly, I had lost patience after the “first day”.  The echoes, bells and whistles had worn me down. I had an Excedrin Plus headache.  Marilyn seemed more pleased than me. I was excited about the events but physically drained — as was Marilyn who had to make sure we handled the cochlear parts correctly.

Looks like an odd version of a “smart” phone, doesn’t it?

We’re into day two. Against my objection, I’m wearing the cochlear parts. I complained, like a whiny kid, but Marilyn was firm that I not shy away from using my new ears even if I’m not comfortable.  I wanted to wait until I shaved and showered but that would’ve been just delaying what must be done. The audiologist was really pushy that I really had to wear them — all the time I was awake.

So, there you have it. Yes, it’s a different world for me now.  It’s a better world.

I just hope those bells are not tolling for me.