Cochlear Implant Progress

Programming for progress

Hearing with a cochlear implant is a work in progress. One part of making progress is programming, also called mapping. To maximize my new hearing, Dr. Paula, my audiologist, must create custom programs based on my auditory response to the electrodes implanted in my ear. With so much opportunity and so much at stake, programming sessions are exciting and stressful.

In the beginning, I had to be reprogrammed every four to five days. This lasted for about a month; my brain absorbed the sound so quickly that it craved more… As exciting as it is, programming always makes me nervous; each time is an adventure. It’s hard because you’re always at the mercy of the technician and the computer. Though you may know and trust the person, you can’t help questioning: How well do they know everything? Do they know exactly how to make it better for me? I look forward to programming days, but with a tinge of anxiety. There’s always the possibility that the result could be worse than what I had before—too loud, not clear. And being two hours away, there was no easy fix for this. I was used to certain programmers, so if I came on a day when they weren’t there, I thought I might be taking a gamble. I would have to work with someone new and would this be a good or bad thing? It was hard to know. Now calculating, I can say that five or so different programmers have worked with me at least 40 or 50 times.

Almost eight months post activation, I will attend program session seven next week. The frequency of my programming differs dramatically from what my Mom experienced in the early 2000s. However, the process is still very similar.

During these sessions, I listen to beep after beep after beep. The beeps increase in volume to help me determine my thresholds—how loud and soft each electrode should be. We also pay attention to my comfort levels. When things are too loud (or there is too much stimulation) my teeth will hurt or my inner ear will vibrate. To keep growing, you need to balance heeding these warning signs with setting your thresholds right on the edge of comfort.

Every time I would go to UMASS, Sarah would expand the thresholds slightly to let in more sound. Three different programs fit on the processor at a time. Sarah would set the first program levels based on how much electrical impulse my ear could handle without enduring pain. She would then make the second and third programs with a 10-15% increase in each threshold. As I finished the first program, I could move myself to the second and then to the third one… I always try to push myself. I would try to hear the softest beeps I could and stand the loudest possible. I wanted to learn and gain sound as fast as possible. There was a certain excitement in this; with the help of others, after each programming, I could usually identify sounds and words that I wasn’t able to hear before. Each time I would come home from UMASS and hear new and different things.

It’s not always easy to predict what may bring on discomfort — screaming, humming, dog whining, electric tooth brushing. During these appointments, once we establish new thresholds and comfort levels, I ask Tim to replicate my trouble sounds and test my comfort. Tim’s a good sport; he hums, whines, and recreates kid chaos right there in the office. While we can’t replicate everything perfectly, I can get a good idea if things will sound good or if we need to make a change.

Here’s my programming crew this past summer.

Finding the language to describe how things sound through my CI is challenging. I love descriptive language, but when describing something that sounds off or unnatural, I struggle to find the perfect words. I use words like muddy, fuzzy, metallic, piercing, and distorted. And made-up words too: hum-y, drag-y, ting-y, slosh-y. Sometimes, I try to mimic the sound’s qualities with my voice and subject the team to my vocal interpretations.. Yet, no matter what I throw at them, with Dr. Paula’s experience, my team can put the clues together and offer a solution that usually does the trick.

After receiving new programs, we play “what’s that?” With my thresholds increased, I can hear more and louder. My brain must take all the new sounds and prioritize them correctly. Trucks and street noise in the background, voices in the foreground. Water is a recent sound — the water in the washing machine sloshing around (I can’t believe you can hear that), and at last, the sound of the faucet I left running.

When I sit on the left side of the couch in the family room, there is still a sound I can’t identify or describe to my family for them to id. I hope that my next round of programming may reveal this mystery.

And, I know this blog was about programming, but look at these donuts from Federal Donuts! After a lengthy programming session, donuts are just what we need. Mom swears by caffeine ahead of programming; my trick is a tasty treat in the city after a job well done.