Update and BAHA Eval

[LizAN]

Hi, all, and welcome newbies!

I had my translab surgery in July, so I am now SSD.  I still have some soreness around my incision and numbness on that side of my head.  My left eye remains bigger than my right, but it's not terribly noticeable.  The wonkiness has improved greatly, however, it is still sometimes present.  My balance in the dark needs more work.  I have been back to work for two and a half months, and life goes on.

I continue to be very happy with my decision to go to House for my surgery. The experience was much easier than I had anticipated.  Other than being off work (i.e. not getting paid) for a couple of months, it doesn't seem like a big deal now.  Wonderful thing, how endorphins (and opiates) cause us to lose our memory of pain!  It was all much harder on my partner than it was on me.  She had to watch me go through this.

Over the last few weeks, I have been evaluating BAHA options.  I have tried all four processors, from two different companies and with two different power levels.  I know for sure that I will go with one of the power options.  My bone conduction test indicated a thick skull, which was no surprise to my family.     I was allowed to take the processors and soft bands home, which gave me the opportunity to try them in different environments.

It is difficult to compare the sound quality of the two processors, on a soft band.  One thing that was very helpful - each company makes a plastic post to which you can attach the processor, and then put it in your mouth and bite down.  This gives you a better sense of what it will sound like on the abutment, since it is directly connected to your skull through your teeth.  I found both processors to be equally clear, using that method, so it did not help much with the comparison, but I was amazed at how much more clear the sound was on the post compared to the soft band.  The softband from Oticon is not, IMO, as effective as the softband from Cochlear.  YMMV.

A lot also depends on how the audiologist sets them up.  Mine was not very experienced, but she was quite accommodating, and had the reps from both companies come to two separate appointments to make sure they were set up properly (this was after my having tried all four and becoming frustrated and confused). 

The doctor associated with this audiologist has implanted less than 20 of these devices.  The new doctor (he was the first one I wanted to see, but I had to wait two months for an appointment) has been doing these for 15 years.  I feel more comfortable with the new doctor because of his experience and because of his detailed explanation of the procedure, however I have spent a lot of time with the audiologist that works with the younger doctor.  I see the new audiologist on Monday.  I have spoken on the phone with her a bit.  She is very nice and seems knowledgeable.  Apparently, her office doesn't let patients take home the devices, but I think they may know more about them.  At this point, I've already had that experience, so I don't need to take them home.  Should I let that worry me about the level of support I will get, after the implant surgery?

As for the processor, I am leaning toward the Oticon.  I found the Cochlear to give feedback, triggered by sounds in the environment.  Touching it was not necessary.  The Oticon occasionally did that as well, but it was softer and not audible to those around me (which was rather embarrassing in a meeting at work.)  I found the Oticon to be much easier to use and the programming options more useful and effective.  It also has an extra programming channel.  I will talk with the new audiologist on Monday about the product warranties, and then make a decision about which device and which doctor.  (I have to decide which doctor to use for the surgery, very quickly, as I have to get this done by the end of December or incur another huge deductible, which I cannot afford.)  At that point, the only remaining decision will be what color best matches my hair!

Thanks for being here.  I don't know how I would have made it through my ordeal without this group and you are still a valuable resource!  I hope I can give back, so ask me any questions you like.

Liz

[leapyrtwins]

Liz -

my neurotologist, who did my BAHA implant, told me that even one implant is enough to make a doctor "qualified" to do BAHA implants.  It was his opinion, and he'd done over 200 implants at the time (March 2008), that a doc didn't have to do numerous implants to be good at it.  He felt that a doc who had performed 10 implants was just as "good" as a doc who'd done hundreds.  Obviously totally unlike AN surgery, but then again BAHA implant surgery is totally unlike AN surgery.

As for the processors.  I have to admit that I'm partial to Cochlear products - I own two that I've been very happy with and I've also been a Cochlear volunteer since 2008 when I was implanted.  I demo'd the Oticon Ponto Pro the same day I demo'd the Cochlear BP100 and my doc gave me my pick of whichever one I wanted.  I found them extremely similar, even posted a comparison on the Forum (you'll find it if you search).  I ultimately chose the BP100 based on Cochlear's reputation, longevity in the BAHA market, and the fact that the design (shape, button placement) was similar to the Divino that I'd been wearing for 1 1/2 years.  I've only had two minor problems with my BP100 and they were both resolved quickly.  I've been thrilled with my BP100.

The feedback you were getting from the BP100 is something that happens until it "gets use to" sounds that it encounters in your environment; it actually "learns" from you wearing it.  For example, when I first started wearing mine it would beep in "answer" to the beeps my car made when I sat in the driver's seat and the bell would "ding" signalling me to put on my seatbelt.  It did this for about 2 days until it "realized" that this was normal sound for my environment; after that it stopped beeping.  Another reason for feedback is improper programming.  I can actually reach up and touch my BP100 while it's on my head and never get a screech.  It won't make a peep unless I forcefully push down on it with my hand.  It's all in the way it's programmed. 

Processors from both Oticon and Cochlear are quality processors - but in the end it's all in the programming.  So whichever one you choose, make sure it's programmed correctly.  And keep in mind that just because a company rep is programming your processor that doesn't mean it's done correctly.  I've participated in two Cochlear workshops where I was involved in training their reps to program the BP100 - it can be tricky and not all reps "get it".  It takes time and patience to tailor a program to a wearer's particular hearing "situation".  But the good news is, once a processor is  programmed correctly for you it shouldn't need any tweaking.
 
Best,

Jan

[LizAN]

Thanks, Jan.

I don't think I can go too far wrong with either processor or either doctor.  It seems to come down to the audiologist.

What questions should I be asking them, to determine who can best handle the programming?  How do I know who has the knowledge and who will be patient and persistent with me? And what do I do, if they do brush me off, or if the rep can't even get the programming to work well for me?

I do know of someone who gave up on wearing her BAHA.  I really want this to work.  Having a BAHA could be very beneficial.

Liz

[CHD63]

Liz .....

I just had a follow-up visit with my audiologist yesterday and learned, yet again, something new.  Long story as to why we were discussing programming, but in her comments, she said programming is not an exact science ..... in that only the patient can tell the audiologist what they are hearing.  There is no definitive way to "set it exactly right for a patient" by looking at her computer screen.  Using the hearing level(s) from one's audiogram and following recommended protocols by the company, the audiologist sets approximate levels.

I do not know anything about the Cochlear BAHAs, but my Oticon Medical Ponto Pro has a feature that enables my processor to "learn" from me.  Initially it learned by whether I turned the volume up or down in various situations and programs (I have 3 programs on mine.).  I rarely alter the volume in mine now as it has "learned" where I can hear the best.

What an audiologist can do is increase or decrease certain frequency levels through programming.  For instance, in my music setting, I wanted more of the low/bass frequencies than I was getting so she adjusted that.

You really only need an audiologist who is available and willing to work with you on the initial programming and then be patient for the first few weeks as your processor learns what you need/want.  The important thing (in my mind) is to put the processor on first thing after your shower in the morning and leave it on continuously until going to bed at night (other than for obvious needs, like swimming/showers, to take it off).  That really speeds up the learning process.

As my mother always told me "patience is a virtue" and that really applies to this process.

Keep in mind the actual abutment conducted sound will be MUCH better/clearer than the softband demo sound.

I love my Ponto Pro and would be most unhappy if I had no input of sound from my AN side.  Let us know what you decide.

Clarice 

[marisa_rivera]

Hi LIz.
We ended up going with the Cochlear brand. My daughter is set to get hers in December!
If you are referring to Dr. Briggs in regards to the younger doctor, he did wonderful when implanting the abutement.
Although I do feel experience w/ an older doctor goes a long way, I think being young has an advantage to always keep up w/ the updates/ new devices that are out.
He did feel that Cochlear was a better brand and felt that they would continue to grow with this device.
But he did leave the decision to my daughter since in the end she is the one that has to use the device.
She did receive feed back on both devices but he mentioned that it would happen regardless and she probably received more feed back that normal since the device wasnt directly attached to the abutement.
I dont think you could go wrong w/either doctor or device

[jaylogs]

Liz, thanks so much for documenting your experiences with everything! I am sure it will help those out there who are just now looking into this wonderful world of AN .  As everyone who has spent any kind of time pouring over everyone's testimony on this forum knows, everyone's experience can and will vary.  But it's nice to just get a general feel for what is out there, like for example Oticon Vs. Cochlear, retro vs middle fossa...things like that! Too bad this thing isn't something you have only one choice and that choice is always good and everything comes out swimmingly, but alas, such is not to be! Anyways, good luck as you continue your journey!
Jay

[LizAN]

Thanks, everyone, for your input.  The decision may boil down to a leap of faith.

Incidentally, I had far less feedback with the Cochlear BP 100 than I did with the BP 110.

I tried the DAI cables with each of the two power devices, connected to my iPhone on Rhapsody.  It was very disappointing that I could not get the volume up high enough with either device.  Even with the processor connected to the test post, held between my teeth, the volume was not as high as with my Scansound Stereo 1-BUD.  It was better, but still not good enough.  How much better do these devices sound on an actual implant abutment, compared to biting down on the test post?

Liz

[leapyrtwins]

I don't have a DAI cable, but I do have a MP3 adapter that I use with my BP100 and my iPod.  The sound is awesome - and no ear buds are required.  It's like having a concert inside your head 

Jan

[LizAN]

Jan,

What is the difference between a DAI (Direct Audio Input) and an MP3 cable?  I thought it was the same thing.

Thanks,
Liz

[LizAN]

Jay,

Thanks for the good luck wishes.

Marisa,

Does Dr. Briggs use the flap method or the slit method for the surgery?

Thanks,
Liz

[dalern]

Hi Liz,
I have the same cable that Jan has and think it is essentially the same thing as the other DAI cable. My situation is that at home, the sound is terrific when I use that cable. Like Jan said, it sounds like the music is inside my head. However, on an airplane, the surrounding airplane noise that is heard by my good ear is distracting.  However, I have remedied that by always traveling with an ear plug.  When I plug my good ear, the audio adaptor sounds great.  Another thing, in terms of programming that. On the Cochlear, there are three programs. There is the standard everyday mode, then the second mode turns off the directional microphone and it only points in front of you (for noisy restaurants, etc) and the third is a choice of either a music program or an audio input program. I tried music first.  I just could not get the sound loud enough to hear well when my iPod was plugged in.  However, when it was changed to the audio input mode, it worked well.  If I am not plugged in and turn it to the third program, it sounds like it is totally turned off.  However, as soon as I plug the adaptor in, the music is loud and clear.  I think the "music program" is for someone who wants to hear better at concerts, etc. I think a lot of it depends on the audiologist and the settings that are established. It was interesting what you said about less feedback with the BP100 than the BP110.  My experience has been the opposite.  Much less feedback with the BP110.  I still have some intermittent problems, but I have adjusted to them and am much happier with the BAHA than without it. If I had it to do over again, I probably would have gotten the Oticon. My abutment is the newer one, so it is not interchangeable.  Good luck, and glad to hear you are doing well.
~Dale

[LizAN]

I am pretty sure that when I tried the DAI cables, the processors were set up for a dedicated channel with no outside sound coming through.  Maybe I just have a very thick skull, which makes me wonder if I'm a candidate for the Cordelle.  I *was* told that my bone conduction test results were not what they expected - they showed that I needed the Power upgrade - the BP100 would not be enough.

As for the music program, the Cochlear rep said that it allows sound to come through that would normally be blocked by the feedback filter.  In other words, in normal mode, you might not be able to hear the flute because the processor might mistake it for feedback.  I went to my kids' orchestra concert with the BP110 in music mode.  I heard a lot of feedback that was also audible to the people around me - not at all what I had in mind.

As much as I miss listening in stereo and would love to have the ecstatic experience of having my head filled with music - it's no longer the main reason why I am getting a BAHA.  I can wait until after my implant is loaded to try the DAI again.  In the meantime, I like the SoundScan earbud just fine.  I'm not sure that I tried the DAI with my good ear plugged, but that might help.

Dale, I would also be much happier with the BP110 than with no BAHA.  Either processor is a huge help, and it has been a tough decision for me to make.

I appreciate hearing from those of you with BAHAs.  It's wonderful to be able to benefit from your experience, and I hope I can help people who are considering a BAHA down the line.

-Liz

[jaylogs]

I got an audio cable for my Ponto. It works wonderfully. It sounds like it's similar in setup to other BAHA's...It has three programs, P1 is for normal, 2 is for my audio cable, and 3 is a custom level, which I use for noiser environments.  It's great because I work in a place where we can't listen to music, especially with ear buds.  But I can get away with using this audio cable because it's not a safety hazard because my ears don't have something in them and I can't hear something.   
Jay

[LizAN]

My new audiologist says that it will sound different on the abutment, even better than on the post between my teeth.  I will try again, after my processor is hooked up.

My surgery is on December 19th.  My pre-op appointment is tomorrow.  Keep your fingers crossed that I don't have a last-minute problem with bloodwork, like I did before my trip to LA.  If I don't get the surgery by the end of this year, it may be a very long time.

Liz