Tuesday, 22 October 2013

BAHA - Day 12

Well, here I am again. I've deliberately not posted any updates for a while so that I could see how things settled down following the fitting of the sound processor and so that I could provide some useful information based on my early experiences.

I attended the outpatient department on the 17th which would have been BAHA Day 07 and the dressings were removed to reveal the titanium implant to which the sound processor would be fitted, this is what was underneath the dressings.

The nursing staff that removed the dressings were extremely pleasant and explained everything clearly, the wound seems to be healing nicely, the stuff above the wound in an antibiotic ointment which has to be applied daily for a while. A probe of some sort was attached to the implant and I was told that the function of this was to check the implant/bone interface to help establish whether things were settled enough for the processor to be fitted, apparently they were which was good. Once this was established and the ongoing care routine instructions passed on I was sat outside to wait for the audiologist to fit and set up the sound processor.

After a short time I went in to to next room where I was introduced the the sound processor and given initial instructions about the various switches on the top of the unit and generally how to use it, it all seemed pretty straightforward.

Then we came to the hearing test which was done with the sound processor connected to a PC which had various software on it to allow the processor to be "matched" to my hearing, or lack thereof, based on previous hearing tests. To be honest this part of the process was a bit of a disaster.

For some reason, something to do with the "team" having to be close together the hearing test was conducted in a room which had a standard room door leading onto a busy corridor, the corridor itself has a hollow floor which generates a hell of a racket with people walking back and forth. On top of this the room was directly adjacent to a children's play area full of toys, which was in enthusiastic use at the time.

It would have been difficult to design a worse environment to conduct a hearing test even if one tried, possibly an airport runway might have the edge. I commented on how unsuitable the environment was but was told that things were that way for organisational reasons. I'm no expert but there MUST be proper sound booths in the clinic/department for this sort of test to be performed in, the current arrangements inevitably result in a sub-optimal test which surely can't be compared to a result obtained in standard conditions?

The problems of the testing environment are evidently recognised. The audiologist at one point went and put a "please be quiet, hearing test in progress" sign on the door which made no difference at all, other than to confirm that this is a known problem.

So, we've now had the test done and the processor fitted, below is how it looks today. This is a very close photo which makes the unit look very large, in fact it is about 20x25mm.

So, what are my early experiences?

I have to be honest and say that when I left the clinic and walked through the hospital and into the outside world I was very disappointed, the outcome was not at all what I had hoped for. Having gone through the operation and the healing period and having had such high hopes I really felt disappointed. My initial reaction was that the unit itself seemed not to work as well as the basic "test rig" I had tried several months ago when I was first evaluated for the procedure. The new unit just seemed to be picking up sound but not in a consistent way which was useful to my brain. Some things seemed louder and some things it didn't seem to pick up at all. I was surprised when I stood  a little way from some people talking on my left side that I couldn't tell what they were saying, I had been able to do so with the "test rig".

That was 5 days ago and I have now had the chance to try the BAHA in a number of different environments and to get a far better idea about it's capabilities and limitations. The summary of my experiences so far would be that in some situations there is a definite benefit but that in many situations I have been unable to identify any clear benefit. I have tried to summarise things below, bear in mind that I am deaf in my LEFT ear:

Definite benefit in the following situations:

  1. Listening to radio whilst driving.*
  2. Listening to passengers whilst driving.*
  3. Lying on right side.
  4. Watching television.*
  5. 1-2-1 face to face conversations.*
* In these situations there was an improvement though I had managed in the past.

No real benefit in the following situations:

  1. Walking about anywhere outside, even a light breeze renders the device useless.
  2. Walking along corridors indoors, air movement causes significant and intrusive wind noise.
  3. Sitting in a cafe. I can hear more on my left side than without the BAHA but the sounds I can now hear tend to be confusing rather than helpful.
  4. I had hoped that in public situations if someone spoke to me on my left side that I would be able to hear them without having to ask them to repeat things, this has not so far been the case.
Where does all this leave me? After five days in all honesty I currently do not feel that the benefits which currently feel limited outweigh the inconvenience of wearing the unit and the ongoing care the operation site will require. The fitting of the unit has definitely not, for me at least, so far been a game-changer.

I fully accept that these are very early days and that it might be possible for things to be improved with further "tuning" and that as time goes by my brain may get better at making use of the additional information it is receiving. I did also read about one case where the unit that had been fitted to a lady from new was actually faulty and she had been struggling for months to find any benefit until the fault was picked up!

It is probably unlikely but it may be possible that the hearing test conditions contributed to the setup of the BAHA not being ideal but this must be unlikely as test will have been conducted on many other patients who presumably have gone on to gain real benefits from their BAHA unit.

My general feeling is that for most of the time there seems to be very little sound, particularly quieter sounds, being picked up by the unit or at least not being heard by me. It seems to me that a lot of sound falls below some kind of "sensitivity threshold" and that I miss things because of this, it's almost as if there is a delay before it gets going! With the BAHA switched on if I rub my fingers together quite hard right next to the processor it seems to pick up absolutely nothing. If I do the same on the other side I can hear it very very loudly and clearly, it just doesn't seem very sensitive. Strangely if something rattles I seem to pick that up better, even though it may be quiet.

All in all I feel that there must be things that can be tried to improve things or as things stand I've got a titanium implant in my skull as an ornament! My plan is to telephone the helpline in the next day or so and see if they can suggest anything. I'm not giving up yet but the bottom, line as things stand for me at least, is that the benefits so far don't outweigh the inconvenience of the implant and sound processor.

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