My cochlear implant is working. I know that because I keep hearing things I have never heard before. I recently heard music playing while I was driving with my daughter. The stereo was off. My phone wasn’t playing anything. Eventually, I realized I was hearing the music leaking out of her AirPods. She was sitting in the front passenger seat and I could hear it from the driver’s seat! That’s ridiculous. And yet, put an actual human being three feet in front of me and ask them to speak? Muddy. Low-pitched. Clearer than when I first got activated, but still not totally understandable.
Make that make sense.
I have been complaining about this problem since I got activated. But since it was all so new, I figured I would just have to “adjust” more or “rehab” harder. I wear my CI for 16–18 hours a day. I have long days, and I enjoy hearing with it. But I just don’t enjoy talking with it. Put me outside with birds and environmental sounds and I am fine. Put me in front of a conversation and I’m still struggling. Voices are still deep, muddy, and difficult to understand.
And while I can increase the volume, I cannot increase the clarity. I cannot just make things louder and then understand. I wish that was the case, but it is not. And it’s frustrating. If people spoke to me a single word at a time, I’d probably be fine because I hear words, but I do not hear speech. And that is completely different. So while I can tell the difference between hand and man, girl and twirl, and boy and toy, I cannot necessarily understand when someone says: “The man took his little girl to the park where she played and twirled while a little boy played with his toy.” I just smile and say, “That’s great. That sounds great.” Because, yeah, sometimes there is just too much to unpack.
So here I am, almost three months post-activation, and voices are still low. Speech—and music—are still muffled and not clear. And that drives me crazy. I am okay with progress. What I’m not okay with is simply waiting around to see if progress happens. So I started reading. And for those of you who know me, you know I get into all kinds of trouble when I read (house renovation ideas, anyone?).
During all of that reading, I came across a forum for cochlear implant users discussing MED-EL’s Anatomy-Based Fitting, or ABF. One post immediately caught my attention. A gentleman said he was six months post-activation and voices were still muffled and unclear. Well, hello there, my little friend!
What really caught my attention was that he didn’t just say, “Eh, ABF didn’t work for me.” He explained what had been changed in his programming and why a different approach worked better for him. That sent me down another rabbit hole. ABF uses information about the anatomy of the cochlea and the position of the implanted electrode array to help determine how frequencies are assigned across those electrodes. That sounds pretty damn logical—especially for someone like me, whose cochlea is longer than average. But it also made me wonder. What if the setting that makes the most sense anatomically isn’t necessarily the setting that sounds best to my brain?
I won’t bore you with all of the technical details, but I immediately requested my information from Allyson, my audiologist. Why? Because now I have a journey to go on. I am not saying ABF is a bad program. It clearly works very well for a lot of people. It may ultimately turn out to be the best approach for me, too. But at this point, I’m ready to ask: How do I know this is the right program for me if I’ve never experienced anything else?
This is exactly how I was with hearing aids. “Better” is not always good enough. Better is just better. But better can also be better. And that’s what I want to find out. Is ABF the best setting for me? I don’t know whether moving away from Anatomy-Based Fitting will fix the muddiness. Maybe it won’t. Maybe ABF really is the best map for my anatomy and we simply haven’t found the right adjustments yet. But I do know something I’ve known since I was a little girl sitting in a sound booth waiting for a beep: Hearing something and understanding it are not the same thing. I spent decades wearing hearing aids that could make the world louder. What I wanted was clarity. What I needed was clarity. Almost three months into cochlear implant hearing, I’m hearing more of the world than I ever have. And that’s extraordinary. But I’m still wanting the same thing: Clarity.
There is only one way to find out whether I can get closer to it. It’s time to step off the cliff. Leave the known zone and strike out for the unknown. I’ve already done that once. Now it’s time to do it again. At my next mapping, we’re going to test whether alternative programming can get me closer to where I want to be. Maybe it will. Maybe it won’t.
But I’d rather test the possibilities than sit around waiting for my brain to magically figure everything out. I’m not looking for perfection, I’m just looking for progress. And sometimes progress means being willing to change what is already better to find out whether it can be better still.
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