Saturday, October 16, 2010

Alvination

The Nucleus 5

drf.com


One month post-op, my new implant gets mapped for the first time-the hook-up, switch-on, turn-on, activation, etc. It’s called different things, but it all means the same thing: It’s being mapped for the first time in the newly implanted ear. A map is the comfort zone of the cochlear implant (CI) recipient. It is the adjustment of how the certain low to high tones and pitches are at the comfortable level or too soft or too loud.

My audi, "Amy", called my name in the waiting room. I met yet another intern who wold be working with her.

Amy looked at my incision to make sure it was healing and that there was no sign of infection. I had a small scab at the bottom of the incision, but everything else looked good. I was to rub the area of the scab gently after a shower.

She asked me if I wanted white. In a previous email during the summer, she asked me which color I wanted for my processor. There were five color choices: White, gray/silver, black, brown, and tan. I chose white. She had to ask because once the package was open, it was not returnable.

She and the intern were opening different parts of the processor, such as batteries, coil, cable, magnet, etc.

She connected a long cord to the processor. The other end of the cord was plugged in to the computer. It would feed information into the internal implant and processor and the computer software.
She anchored it on my ear and put the magnet on the internal magnet that is located behind the ear. (I now have double the “magnetism”.Winks.) .

Then she had me tell her whether the sounds were too soft, soft, comfortable, and loud/too loud. Sometimes it was hard to tell if I was hearing anything. I believe she only hooked up five different electrodes (out of 22) because it was a lot of work and time to have all 22 set up.

It was now time to go “live”, that is, turn on the processor and see how everything sounded. I had to take off the processor on the other ear.

I could see Amy’s mouth moving and heard a distorted Alvin. I heard everything in high pitches…almost. It was “heliumized,” but I say “almost”. It was a bad imitation of Toon Town voices, you know, like Mickey Mouse and Daffy Duck. It didn’t sound good. (Hence the title of this post, “Alvination” instead of “activation.”) It wasn’t like the motorized sound I got the first time around. That ear didn’t pick up speech for about 15 years, so it had work to do. This ear had work to do, too. I felt like it was too loud, though.

Amy lowered the volume. Still too loud. She lowered it down some more. It just wasn’t comfortable. I kept hearing a sharp “ssss” at the end of each word. I think she must have turned it down about three more times. Then she said that I should put on the other processor. How was it now? Could the volume go up now? I was surprised to find that I could tolerate more volume. (This audi certainly knows how to do her job.) The “ssss” sounds I heard was because the ear wasn’t used to hearing higher pitches that the hearing aid could not reach. I listened some more. I could hear the intern’s footsteps. I heard a rubbing sound. I glance at Hubs and he was making his shoes squeak. (His “devil’s horns” were coming out.)

Each program of the processor had volumes louder than the next. I can move up through the programs when I am comfortable with the volume. I remember when I did this with the first implant. My brain just soaked up the volume so fast that at each visit, I maxed out all the volumes from programs 1 to 4. The other programs like music and focus would not be added till my brain adjusts to the sounds. What good would that be if I wasn’t at my best “hearing”, that is, used to hearing sounds and speech and tried to listen to music on the special music program?

Amy showed me how to put the processor together. The Nucleus 5 was much different than the Freedom, which is the processor I used with my first implant. Cochlear came up with a new model (Nucleus 5 or N5) last year. She demonstrated how the parts “snap” on-the cable to the coil, the cable to the processor, how the battery (both the disposable and rechargeable) snap on the bottom of the processor. It was slimmer than the Freedom. The Freedom’s cable and coil is all one piece and all you had to do was put it in the space provided for it in the processor.

She demonstrated how to place the rechargeable batteries in the recharger. There were four spots to put a battery in. I had to put it in the 11 o’clock position and kind of twist it in to the 12 o’clock position, much like how I put the Freedom’s processor apart. I did it the same way when putting the battery on the N5 processor. (I got two standard sized rechargeable batteries and one smaller rechargeable battery.) Amy estimated on her computer that with the mapping I had, the standard battery would last about 23 hours and the smaller one would last about 15. And as usual, always rotate the batteries so they all last a long time. (Here I'm thinking, but happens when they all become "unrechargeable" around the same time in about 3-5 years-depending on the life of the rechargeables? I think the Freedom rechargeables last that long, but I don't know what the life of the rechargeable is. That would put a huge dent in my bank account to buy 3 new rechargeables...) With the Freedom, I got only two rechargeables and it came with a different recharger.

Also, if you took the N5 processor off the ear and left it sit, it would automatically shut itself off within a minute or so. The Freedom would stay on. So many different features!!!

The remote assistant that came with the new processor will take some getting used to. I was given a crash course on how to use the remote. I thought it was cool that, on the remote, I could go from P1 (program 1) to P3 or P4. I could skip between programs. With the Freedom, I had to keep pushing the button on my processor to move from P1 to P2 to P3 to P4. It was always the same. If I wanted to go to the music program on my Freedom, which is P4, and I was on P1 (everyday program), I had to push the button three times to move from P1 to P4. With the N5, I could just zip from P1 to P4 with one button on the remote. How cool is that? But just going through that quick “how-to” was too much to take in. Information overload. I’m going to have a LOT of reading to do to get more comfortable with the remote. I have an interactive disc I can use on the computer to use with it, too. Cool!!!

I have replacement parts for the microphone part, but it’s much smaller. They have to be replaced about every six months. I got a lot of goodies in the kit. (I call it the “goody box” instead of “goody bag”.) There’s so much to list. I did get blue covers for the processors, some cable for the TV to hook up with the processor for better listening, and my soon-to-be favorite item when my new implant adjusts with the sounds-a cable for the MP3 player (it’s bilateral so I can plug it in both processors, but it only works on the N5, not the Freedom).

I got a new “Dry and Store” box. I can’t use the Dry and Store I had with the Freedom for the N5 because it had ultraviolet rays in it. The UV rays can discolor the white processor, I think. (When I went home, I put the old Dry and Store away and plugged in the new one.) I can use the Freedom with the new Zephyr Dry and Store Yay.



Zephyr from hearingdirect.com




l

lloydshearingaid.com


I also go this spiffy backpack. It’s bright yellow and black. It’s one strapped, so you can just hang it over one shoulder. It’s pretty neat, the little pockets are placed at different angles. I thought it was really cute. My 10-year-old wants it. Nope. It’s MINE. lol. (I don’t think it could hold a lot of schoolbooks anyway.

The intern was going to give me a quick hearing test. It was just to see how much sound I was hearing from the lower pitches to the higher pitches. I wasn’t hearing anything. She came back in the soundproofed room and told me she was going to ask the audi a question. She came back with another audi and they worked on the testing together. Still nothing. The problem? Well, back in the audi’s room, while I was given a crash course in how to put the processor together and how to work the remote, the processor sat out over a minute and shut itself off. (I didn’t even notice that when I put it back on my head. I had a hard time finding the magnet because it was a bit higher on that side than the other side.) Duh, I didn’t even notice I didn’t hear anything after being distracted by trying to find the magnet and because I was already hearing with the other processor. LOL Note to self: Make sure the green light is on the processor to tell you it’s on.

Okay, the processor is turned back on and now I hear the tones.

The result? It was varied between 20 decibels to 35 decibels. I went from severe to profound hearing loss in that ear to mild hearing loss. Keep in mind, though, that without the CIs on, I'm deaf and that I still can miss things with the CIs on.

So, now I will have another mapping and more electrodes turned on at the next visit in two weeks.

When we got back in town, Hubs stopped at the “man’s store”, the local hardware store, Fleet’s Farm. He left the radio on. While he went to shop for a couple of items, I demagnetized the processor on my first implant and tried to listen to the radio. The music was going to take time and I expected that. When the song ended, a male voice reported local news. I was actually HEARING a word here and there. They weren’t “heliumized”. It was almost normal. Wow. I was impressed. I couldn’t believe it. It wasn’t 100%, of course, and I didn’t expect to hear some things as clearly as I did, either. (And it was only a little over an hour after I left the audi’s office. Now that’s what I call PROGRESS!!!

All I can say right now is that the first implanted ear, which I named “Pete” btw, is doing the job my hearing aid (HA) did. It’s balancing it out, making it “natural”. The past two years I didn’t go without the HA/CI combo (bimodular) because I liked the “naturalness” of the sounds the HA gave me with the CI. Now Pete is going to help “Repeat” (the name of the second implant) adjust to hearing at higher levels.

Right now, as I click-clack on the keyboard, I am hearing it differently. Much more defined, clearer. What a difference!! I am sure Pete and Repeat will work together nicely.


Postscript: I watched TV. I took off the first implant and just tried to make sense of the Alvinized voices on the TV. I followed the captions and the words spoken matched the voices, but I couldn't make out the words that much without reading the captioning.


And before, while I was on the computer, the clicking noises of the mouse as I right-clicked or moved the cursor around, it made sharp clicking noises from my right side, where the new implant is. Surround sound is coming along, slowly but surely. :)

Saturday, October 02, 2010

Post-Op Recovery

Wednesday night

After coming home a few hours after surgery (yes, it is considered an outpatient procedure),
I was only able to sleep 1 ½ to 2 hours at a time. I slept downstairs on the couch for the next week and a half.

Hubs cut up some watermelon and made cucumber salad. That was pretty much what I ate for the next two days.

I did not have any bouts with nausea since leaving the hospital, except for Friday night, I felt some nausea, but it could have been the pain killer.

The kids still had school so I was able to veg out without interruption during the day. I faithfylly took my antibiotic medicine three times a day for a week. I only took painkillers as needed, but I only took some for about two days.

Friday I got the "face-enhancing" headband off. I did not get the “big relief” I got the first time around. I still felt weak. My neck felt stiff on that side and my jaw hurt. I couldn’t open it wider than an inch. I thought it was the headband that put pressure on my jaw that made it hard to open, but it wasn’t. I tried to joke that maybe I was “knocked out” in the jaw instead of anesthesia prior to surgery.

It felt good to shower and wash my hair. I noticed that the incision was along the back of my ear instead of along the hairline like the other side. I wondered if that made a difference in why the jaw hurt (having the incision closer to the ear and jaw). Then again, there are several nerves (facial nerve, taste nerve, and one other nerve I can't think of now) that could have be disturbed during surgery.

I ate flattened toast and soup for the next couple of days and still slept off and on through the night.

But I did notice something: I had NO taste disturbance this time. I had to test it a few times to make sure by chewing food on one side of my mouth and then the other. Nope. I did not lose my sense of taste.

Sunday, four days post-op, I washed three loads of wash and did some cooking. I felt so weak. Maybe I did too much too soon, but I had to do some picking up around the house. It wasn’t going to clean up by itself. (With the first CI surgery, I don't remember this weakness. I was totally zapped. Imagine grabbing a chair by the stove and browning some meat. That was how weak I was.)

On Wednesday, the week after, I had a date with a steamroller. This was also the day I was under attack by germs. Yep, I caught a cold. My husband caught one a few days earlier and I guess I must have touched the remote or computer keys or something else he touched and got sick. I had a cough and runny nose. I was a drippy faucet for two days.

The steamroller, you ask? The mammogram. Maybe that’s not a good enough description, but it does “flatten”. After the results of my mammo, I had to go back on Friday to have it done again. Gah. Turns out I have a cyst and they want to keep it monitored.

The next four days were tough. It was hard not to blow my nose. After a CI surgery, you are told not to blow your nose. If you have to sneeze, keep your mouth open. You even “grounded” from flying an airplane unless the doctor says otherwise. You have to avoid anything that may cause your ear to pop.

Let me tell you, there were times when I’d forget out of habit and start to blow. In mid-blow, I’d feel this unpleasant sensation of my eardrum expanding. I’d freeze, “Oh, no.” Then it’d pass. I pretty much just kept a Kleenex in my hand to catch the drips. I was thinking about tying something around my head to keep the Kleenex in place so I could be “hands free”, but decided I’d look ridiculous.

By Sunday, a week and a half after surgery, I felt more like myself. I kept dabbing antibiotic cream on my incision twice a day.

I got my stitches out the next day. The incision looked good. I told the doctor that there was no facial paralysis or taste disturbance.

It just seemed like it took me longer to recover from the surgery than the first time. Maybe because of the cold or maybe every surgery is different.

I am getting better all the time. The ear still feels rubbery. It might be a good four months before my ear feels “normal” again.

Next: The activation. Stay Tuned.