Tuesday, July 21, 2009

The Unpredictable and Unexpected

Since my last posting, things have been interesting. I’ve had a couple of potholes but I’m getting around them and starting to settle into enjoying having both implants. After a month of almost weekly sound mappings, we’ve finally reached a place where I can comfortably wear both implants! They’re loud enough for me to enjoy the directionality of sound as well as increased comprehension in unfavorable listening environments such as loud restaurants or echo-y rooms. But getting to this point was an uphill battle. Ginny reached out to Advanced Bionics, the manufacturer of my implants, for support because we couldn’t figure out why I was experiencing what I was experiencing. Wearing both implants together was creating something called summation: 1+1 was not 2; rather, it was 1+1=3. Having stimulation in both ears was too much for me to handle. I was feeling breathless, my heart rate would accelerate, and I got hot all over my body. In short, I felt like I was having small anxiety attacks. After what feels like 100 sound mappings in two months, I’m doing so much better. The only downside is I still can’t wear both when I’m on the phone. A phone conversation is too intense for me to wear both – but I can control that experience easily by simply taking one implant off during the phone conversation. However, we do have a long-term goal of being able to wear both consistently in all listening environments. Considering I was panicking that I wouldn’t EVER be able to wear both comfortably, I’m fine with taking one off just for phone conversations!

To throw in another monkey wrench, I developed a post-surgical complication. A small air pocket has formed between my skin, skull, and the implant itself. Every time I would blow my nose or sneeze, air would travel up to the surgery area and push the magnet off my implant enough to turn it off. To get my implant to turn back on, I use my fingers to push the air around and squeeze it out. Weird? YES! Of course when this happened the first time, I freaked out because I didn’t understand what was happening. The medical explanation is that the tissue around my wound has not healed properly so an air tunnel has formed. We tried to speed up the tissue healing process by putting a pressure wrap on my head for 2 days. A pressure wrap is what I came home from surgery with (see the picture!). Going to work for 2 days looking like I just walked out of brain surgery was … interesting. Needless to say, I hid in my office behind my cubicle as much as I could. When the wrap came off after 2 days, I was under strict orders not to blow my nose, sneeze, or otherwise create pressure in my sinus area, for 2 weeks. I was a very good patient. However, the first time I blew my nose (GENTLY!) 2 weeks later, I felt that pocket fill up with air immediately. So it hasn’t healed and I see my surgeon on Friday to figure out how to fix this issue. Stay tuned.

While all this has been going on, I’ve been tending to a back injury. (This has been my year of medical issues…I feel like an 80 year old woman with how many times I have doctor appointments!) It started back in April when I started feeling sore in my lower right back. I chalked it up to a pulled muscle and didn’t give it much thought. Well that sore area over the course of 2 months developed into persistent sharp pains that have derailed me from running, twisting my torso, bending, and standing for long periods of time. I finally gave in and went to my doctor…who then referred me to a spine specialist… who then referred me to 6 weeks of physical therapy with a preliminary diagnosis of arthritis. After a few weeks of physical therapy and no relief, my new diagnosis is a bulging or herniated disk. My therapist would love to do an MRI to confirm this but with magnetic plates in my head, this is not an option for me. When first considering cochlear implants over two years ago, the fact that I couldn’t get MRIs did not faze me. I’m a healthy woman in my mid-20s - MRIs are not a part of my existence! Now that I’m actually in a position where an MRI could help me, it’s a tad frustrating. I console myself by saying MRIs don’t show everything 100% of the time. So we’re taking the old-fashioned route by doing physical therapy until something works. Blah. Did I mention I feel like an 80 year old woman this year?

Now that both implants are on and working, I’m definitely enjoying the ease of conversation in group settings. I was at a happy hour last Friday and happened to sit next to an ENT doctor from the Philippines who is observing in our clinic for the summer. She told me all about their health care system and their audiology and cochlear implant practices in her country. I was able to hear her just fine with all the chatter going on and with her sitting directly to my right. Then, my co-worker, sitting to my left, told me all about her fitness competitions, and I didn’t have to swing my body around to hear her properly. It is wonderful to be able to switch back and forth between people on different sides of my body without having to worry about shifting one ear to hear well. It’s a small thing but it relieves so much stress for me in social situations. So despite the air pockets, the weird physical experiences, and millions of mappings, I’m still happy with my decision to pursue a 2nd implant. It has been an adventure and at the very least, keeps life interesting.

Love,
Becky

Tuesday, May 5, 2009

Undefined Progress

Spring is one of my favorite times of the year for all the sounds I can now enjoy. I'm sitting on my back porch after supper enjoying the chirps of the birds; crickets in the morning; it is so loud outside now! And then of course, the blooming flowers as winter melts away to spring.

I'm sitting here with both implants on. I can hear out of my original and while my new one is on, it isn't quite loud enough for me to tell it is on. But thats okay - they're both on my head at the same time and that is big-time progress in my book. We've managed to find a set of maps that doesn't make me cringe everytime my dog's nails click on the hardwood floors. I'll take it! (For now.)

Last Wednesday was my most recent mapping and it was my 3-week follow-up from activation. I'm a rock star in the ol' sound booth - I got 80% of my words right with my new implant, something like a 14% increase in my sound comprehension from just a few weeks ago! Ginny was impressed and even I was surprised at my results. What can I say? Practice makes perfect? :)

The downside is that while I'm rocking each implant alone, they're refusing to get along. Kind of like my older brother and I when we were 6...and 10...and 13....and 16... you get the idea. There are times when I can tolerate the two together - quiet car rides home, with just a low, steady hum of the car in the background. Other times are more difficult - like two-day conferences with 8 people at a meeting chattering from all different directions. My team still isn't quite sure what the problem is but we're consistently trying new approaches. I see Ginny tomorrow again for another set of maps to try. I also see Nanette, my speech pathologist, for another session of listening therapy. I'm very excited about this appointment because I want to see how I'm doing with my "mmmmm"s, "oooooo"s, and "eeeeeee"s.

In the meantime, I'm definitely enjoying having my old implant back on for most of the day. I've already called my parents several times this week! I appreciate the ability to catch up with them at the end of my days as I'm driving home from work. Oh and speaking of phones... I'm one of those rare persons who had only had two phones in about 10 years. Yep, I use them until they break - pretty much how my father drives his cars (until they die in the middle of busy streets). My contract with tmobile expires at the end of this month which meannnnsss...phone shopping for me!! Should I get an Iphone? A blackberry? Oh the choices are endless!!!

Love,
Becky

Monday, April 20, 2009

Trying to Connect the Dots (or something like that...)

Last week was another week of ups and down. Man, this trip around has been more complicated!

We'll start with the good. I had my first listening therapy session with Nanette on Wednesday and that went really well. We worked on the three sounds that are most difficult for me to distinguish between: "oooo", "eee", and "mmmm." At first, it seems a little strange that "mmmm" and "eeeee" would sound so similar, doesn't it? Nanette's explanation makes perfect sense. The cochlea is shaped like a seashell in our inner ear and there are millions of tiny hair cells circulating throughout. The hair cells at the forefront of the cochlea are responsible for detecting high frequency sounds (whistling, chirping birds, etc.) while the hairs all the way back, deep in the cochlea handle the lower, deeper sounds (lawn mowers, humming, etc.). For late deafened adults or people who lose their hearing from exposure to excessive noise, the high frequency sounds are typically the first to go because those hair cells are at the "front line", absorbing all that noise. Now I swapped my natural hearing system for a man made one and that changes things. My implant is wrapped tightly around my cochlea - it has the most direct contact with the hair cells at the top of my cochlea (high frequency hairs!) and the least contact with the ones way in the back, deep in the cochlea (low frequency hairs). The result is that I become friends with high pitches much quicker and easier than those low tones. It was very satisfying to learn the science behind why certain listening situations are more difficult.

After our science pow-wow, Nanette took me through a series of drills. I had to listen to her say three words, and pick the one that didn't belong: "bike, spider, car". Then, she showed me two pictures of similar sounds and without lipreading her, I had to pick the one she said: "Lou, Low" and so on. The purpose of all these different drills was make those cognitive connections with certain sounds. She'd say a word, I'd lip-read her - identify the word, listen to it again, store it in memory..and then drill it. Its a very repetitive process that can become frustrating and tiring, trying to "learn" all these new sounds. But at the same time, its rewarding and a lot of fun to see my progress! Low sounds like low, and Lou sounds like Lou! =)

So that's the good stuff. The not-so-good stuff has to deal with wearing my implants together. There has been no change - I still feel that weird current shooting through my body when I wear them together. Ginny gave me two really quiet maps to help me tolerate them with instructions to spend about 15 minutes each day with them on together. My care team is doing research, trying to put together a good strategy to get me to a place where I can wear both together, comfortably. At the same time, they're also trying to figure out why I'm having this experience. While I sincerely appreciate their honesty about the situation, its a scary feeling not knowing whats going on. So I'm kind of in this limbo... each day, I wear my original implant by itself for 1-2 hours (typically listening to NPR on my commute which is a nice return!); I spend about 15 minutes with them both; then the rest of the time I wear my new implant. Its weird and uncomfortable and hopefully short-term.

My dad likes to tell me to "suck it up" when I start throwing pity parties for myself. So I'll end this blog on a happy note. On my way home from work tonight, I had NPR on and I noticed I was able to understand a LOT more of what they were saying with my new implant. While I still have a long ways to go, I can at least detect that it'll be partly sunny tomorrow, I think in the 80s. =) Baby steps, right??

Love,
Becky

Sunday, April 12, 2009

BuMpS iN tHe RoAd

This past week has been a little bit of a roller coaster for me. I had my 2nd sound mapping appointment on Tuesday and I was looking forward to gaining more volume and more sound clarity. I completed my assignments over the weekend which consisted of practicing my sentences with Matthew and slowly increasing the volume. After my appointment, I left with three new programs with increasingly louder volumes, all set with Advanced Bionic's signature Harmony 120 feature. The 120 program maximizes my ability to hear the full range of sounds in the environment. This feature highlights chirping birds, smacking lips, crinkling paper, clacking keyboards, rustling leaves, and so on. As soon as Ginny flipped it on, sounds immediately went from dull and monotonous to crisp with multiple tones. Simply put, Ginny sounded like a female again!

As the week went on, I was involved in several meetings that required my full participation. I also had many phone calls to make, multiple conversations with various co-workers... I felt drained by Friday. I feel down on myself at night, frustrated with how much effort I have to spend just to understand a simple conversation. I'm a runner and I do a lot of my thinking and soul searching while pounding the pavement. On my run Friday morning, I realized why I'm having a harder time mentally this time around... I think I'm grieving (temporarily). Let me explain. When a parent suddenly discovers their small child has a hearing loss, most spend some length of time grieving. They grieve for the sounds their child may never hear, the opportunities that might not be realized, dreams that may now be out of reach. Older people who lose their hearing with age experience depression or isolation over the loss of their hearing. Same thing with adults who suddenly lose their hearing from exposure to noise or illness or whatever. This is normal.

With me, I never grieved my hearing loss. Why would I? I don't remember ever being able to hear "normally" - my auditory world, up until my cochlear implants, has always been a weird amplified version of muffled sounds only made clear with lip-reading, sign language, captioning, etc. That was my reality and it was just fine with me. Then, I got my first implant and over time, my auditory world has changed so wonderfully and positively beyond what I ever believed I could hear and understand. I'm more independent auditorily than I've ever been in my life! And I love it! I'm so thankful.

Now, here I am, with my 2nd implant and I'm back in this world of fuzzy noise, muffled voices, sounds I can't identify or pinpoint. Coupled with a career that I love and am so involved in, I have a perfect recipe for frustration and, as I now realize, down in the dumps and missing my nice world of familiar sounds I can access easily. The logical part of me knows this is all only temporary but thats the funny thing about emotions - they don't always respond to logic. But I'm working on it.

There's another little thing we're not sure is an issue. When I put on both implants, it feels like an electrical current is surging through my body. Its so uncomfortable, the only volume I can tolerate is a human whisper. Ginny gave me instructions to wait until this weekend and then try both of them on for 15 minutes to see if time has made a difference. I just got done with that assignment and I'm disappointed to find out that there hasn't been any change. When I asked Ginny if this is a normal reaction, she said no but was quick to add that everyone is different. So I'm not sure what this means but I hope it improves with time. We'll see.

My next sound mapping is on Wednesday, followed by listening therapy. I'm looking forward to getting an even better map and also some answers to this weird bilateral electrical experience. In the meantime, its beddy-bye for me. Happy Easter everyone!

Love,
Becky

Sunday, April 5, 2009

The Return of the Robots

As I write this, I am about 36 hours into the activation of my new implant! I've experienced feelings of dread, excitement, optimism, and being overwhelmed all weekend long.

Dread
Last week, as activation day hovered on the horizon, I became increasingly anxious. Once activated, I am obligated to listen a majority of the time out of my new implant only. I must reserve my original implant for situations where critical information is being exchanged (i.e. meetings, phone calls to parents, etc.) or when I'm simply at my wits end, tired and frustrated. This commitment gives my new implant time to learn auditory processes and identify sounds in my environment without the crutch of the other implant. Learning how to hear with both implants will come later. As I drove to work last Thursday morning, I was listening to my regular morning radio news station ... and I became acutely aware that I wouldn't be able to enjoy this simple pleasure for a while. It took probably 14 months with my first implant before I could listen to the radio and understand an entire spoken story. It was disheartening to think about.

Excitement!
The next day, Friday, April 3, I felt like a kid on Christmas Eve. Its odd considering all week long, I had been experiencing a Pandora's Box of negative thinking - focusing way too much on the downsides of starting over with a new implant. But it must have been a healthy form of mental processing for me because by the time I was sitting in my audiologist's office, I felt mentally prepared for the tasks ahead of me. More than that, I was excited! This day marked the first step toward achieving my fullest potential as a listener. Matthew and Jane (my mother-in-law) accompanied me to the appointment. Ginny, my audiologist, started pulling all the equipment out for activation and I felt like an old pro. I recognized all the pieces and was comfortable handling my new $7,000 (thank you health insurance!) processor. Even though I had been through this once before, Ginny was careful to take a few minutes and talk about reasonable expectations. Then ...drum roll... I was turned on. And the robots came marching right in.

Optimistic
As I sat in the chair with my new implant turned on, I felt like the sound I was hearing was literally pulsating in my skull. We had the volume turned down very low because the stimulation can be painful at first, if not carefully controlled. I haven't worn my hearing aid for 2 years...so it felt WEIRD to have a sensation of sound in that ear. To help my nerves become comfortable with the stimulation, Matthew read a story to me while I kept my eyes closed and focused on whether or not the volume was too powerful. Then, gradually over the course of the 2 1/2 hour appointment, we increased my volume by several levels. Ginny also tested my listening comprehension by having me select the word or phrase off a worksheet that she would say. I did well enough to advance through the first two levels! Even though I can understand over 90% of spoken speech with my original implant, I am back to square one with my 2nd. At the same time that it was disheartening to see how little I could understand, I was also thrilled and excited when I was able to correctly identify a single word or simple phrase just 2 hours into activation. The joy of hearing and understanding has not faded for me. =)

Overwhelmed
Leaving the quiet, safe hospital behind, we ventured out into the real world of bangs, crashes, chatter, beeps, and a million other sounds happening at once. We've returned to our familiar game of "whats that?" I can't tell the difference between my dog's bark, a person sneezing, or a door slamming shut. They all sound the same: "wa wa". My husband's voice sounds like "wa-wa-wa-wa-wa". The coffee dripping in the pot sounds like "wa....wa.....wa...." The phone ringing sounds like "wawawa...wawawaaw...wawawaaw." By yesterday afternoon, I was feeling pretty wiped out. The combination of still recovering from surgery coupled with feeling like an over-stimulated baby, parked me on the sofa last night. I didn't have much more motivation than to get caught up with putting old sensitive documents through our office shredder and listening to the "wa-wa-wa" of the blades. Then, my dad called. I answered and told him I'd call him back when I put in my original implant. Oh boy, having two implants is intense. I actually had to turn down the volume of BOTH because I felt like someone was clanging cymbals in my skull. My head literally felt like it was pulsating from the intensity of the sounds. And all that I was hearing was my own voice! As soon as I hung up with my dad, I took my original implant out and I was actually grateful for the relief. Hearing through two implants is a whole 'nother experience I'll patiently take my time to reach.

Looking Ahead
On Tuesday, I have my 2nd mapping with Ginny which I'm excited about because we'll start focusing on adjusting my programs for sound clarity. These are the mappings that will help the Charlie Brown cartoons retire and human voices return. On Wednesday, I have my very first tistening therpay session with Nanette, my speech pathologist. The appointment is exactly what it sounds like: therapy focused on teaching me how to listen better (Matthew says he likes this but I think he's hinting at something other than my implant!). These sessions will help Ginny program my sound maps more efficiently because Nanette will be able to identify which parts of sounds I have a hard time distinguishing. This multi-disciplinary approach to my care is representative of the Marion Downs Hearing Center, something I find highly appealing as a consumer of their services. I couldn't be in better hands!

We'll see how the next few days go. I so appreciate everyone's words of encouragement and excitement. I'm lucky to have so many people rooting for me as I venture on my "robo-tronic ear" experience, as my cousins lovingly say. Until next time...

Love,
Becky

Sunday, March 29, 2009

Recovery

As I write this post, it has been 4 1/2 days since I had surgery for my 2nd cochlear implant. I feel pretty crappy to be honest, but less crappy than yesterday and definitely less crappy than the day before. Baby steps!

The morning of surgery felt like it dragged on forever. As the nurses hooked me up to my IVs and prepped me for surgery, I found myself focusing on the fact that very soon, I would be totally deaf and 100% dependent on man-made technology in order to hear. I've always used hearing aids to hear but I also always had a little bit of natural hearing just hanging out, ready to be used whenever technology got to that point. When I imagined future "cures" for my hearing loss, it never involved destroying the natural hearing I did have. Thankfully, my medical team whipped me away to surgery before I had too much time to psych myself out. Surgery itself went well and they tested the electrodes while I was in there to make sure everything was working mechanically before stitching me up.

The medical staff was terrific, especially when I woke up. I was in pain and gradually, nausea set on (and would remain for several days). After stabilizing me, I was sent home and plopped down in my big red lazy-boy chair. The pain was controllable with lovely la-la land drugs, but the nausea was my enemy. My taste buds have retreated temporarily so whatever food goes down, is tasteless to begin with. But upon settling in my stomach, nothing agreed to stay. Consequently, for 4 days, my food intake was akin to an anorexic Hollywood super star. On top of that, the morning after surgery, I started itching all over. After discussion with the docs, I was taken off my antibiotic because I was having a bad reaction to it - the medicine was is a different family than penicillin, which I'm allergic to, but apparently my body disagreed with it anyway.

Today, Sunday, I have turned a corner! Frankly I was tired of feeling stoned so I've been weaning off the pain medicine. I had my first full meal at lunch: a tortilla with cheese and an apple. Small victories! Then, since I had a serious case of cabin fever and my back was taking on the shape of the lazy-boy chair, Matt and Jane took me on a car ride to a local park where I sat at a picnic table and enjoyed some fresh air and sunshine. Vertigo only happens when I look down so I try to keep my chin up! I made it a point to move around today and I can feel it; I'm pooped. Its 6pm and the rest of my evening will be spent watching tv and dozing.

I appreciate all the well wishes and cards/flowers/plants/brownies I've received from everyone. I was dreading this recovery phase like the plague but now that I'm over the hump, I'm starting to get excited for activation on Friday!

Love,
Becky

Tuesday, March 17, 2009

Subscribe To Receive Email Updates!

Many of you have asked for a way to automatically receive email updates of when I post to my blog. Unfortunately, this blog site does not have an easy solution for that. So if you'd like to receive updates, I can add your email manually from the back-end. Either leave a comment on this post with your email address, or send it to me at rebeccanovinger@gmail.com.

T-minue 7 days!

Thanks!
Becky