I Think This Is Good...

When we left Johns Hopkins yesterday, Laynie was not sure about her new map. She thought it was too quiet. But she thinks that after every new map, and then the next day it seems louder. It's like her brain takes time to realize that things have changed.

Sure enough, today things have changed. I can't remember if it was when we were doing listening therapy or if I was just talking while signing, but something I said made her wince... and not the content ;). She thought that maybe her high-pitched-sounds-bother-me problem was back. But speech sounds had never bothered her before; the culprits were things like plastic bags and running water. Of course, we decided to test what bothered her. We both have a healthy amount of scientific curiosity (OK, we're nerds). So, I said, "Sssssssssssssss," as loudly as I could, close to her. It wasn't too bad. Same with "shhhhhh." I said, "Eeeeeeee," and it was immediately apparent that the /i/ sound bothered her. I thought that /i/ had a second formant... oh, brother, I'm going to have to explain this.

Vowel sounds have two main frequencies, called formants. The relationship between the two formants is how we know which vowel we hear. There you go.

So I thought that /i/ had a high second formant, somewhere around 2000 Hz. Believe it or not, I remembered this because of a project I had to do for Speech Science class in 2006. Thank you, Dr. Dromey.

I wondered if Laynie might have gained ground in the mid frequencies, 1500-4000 Hz, and that those might be what was bothering her. I tested other vowels, and /i/ and /e/ ("ee" and "ay") were the worst for her, followed by /ae/, the short "a" sound, as in "hat." Because my nerdiness knows no bounds, I located a chart on the internet that contains vowel formant information. It was on Wikipedia, which means there's about a 50/50 chance that it's correct, but it did seem to agree with what I remembered from Speech Science and Physics of Acoustics classes.

Yes, aren't I the smart one. Mid frequency second formants. Another website said that nasals have formants around 2000-3000 Hz, so I checked, and /m/ and /n/ bothered Laynie, as well. Laynie suggested checking this using the piano. What a fine idea.

Ah, the internet, treasure trove of information. Naturally, it was easy to find a key-frequency correspondence chart for a piano. And, as an added bonus, I knew that my piano would be quiet accurate, having been tuned less than two weeks previously.

The piano proved to be an excellent resource, supporting my supposition that frequencies between 1500 Hz and 4000 Hz were bothering Laynie. Actually, down to 1300 Hz bothered her.

I know that these sounds are torturing Laynie, and that she now hates a strident or brassy voice more than ever, but I think this might be excellent news.

Another Mapping

It looks a bit different today.

Laynie had her three-month mapping today. She was disappointed to test at 35-45 dB for 125 Hz to 4000 Hz, because she was hoping for 25-30 dB across the board. She was still at 25 dB at 6000 Hz and 20 dB at 8000 Hz. High frequencies certainly are her strength these days.

Steve, Laynie's audiologist, redid her map from scratch, which was a great idea, in my opinion.. exactly what I was hoping he would do. I guess you need some context to understand what that means.

When Laynie's implant was activated, on February 13, she got her first map. A map is basically a computer program on the cochlear implant, and it controls how the implant processes sound and the way it stimulates her nerve fibers. The Med-El Sonata implant, which is what's in Laynie, has 12 electrodes. At the first mapping, Steve programmed each electrode by asking Laynie to tell him when the sound (beeping) was comfortably loud. At the second mapping, he took that same map and just made it louder. At the third mapping (and the third mapping was only a week after the first one), I think he increased the loudness and had her listen to electrode one and compare the loudness with electrode three, etc., trying to even them out a little. He didn't start over, just refined what she already had. At the fourth mapping, which was two weeks after the third, he kept the same map and made it louder. At the fifth mapping, Laynie told Steve how much high-pitched sounds were bothering her, and he decreased the stimulation on some of the electrodes and increased it a bit on other electrodes. I mean, more goes on at these appointments, like checking nerve responses, but as far as changes in the maps, that's it.

I don't think Laynie had enough "sound knowledge," if that makes sense, to give him decent feedback on what she was hearing. He did not test what she was hearing until the fourth mapping, and the only testing he has done it pure tone (sound field) audiometry. No speech recognition, CNC words, spondes, or sentences. Laynie would do poorly on those tests, which is probably why he has not done them. Although, I do think there is value in having low scores, because you can measure progress from them.

So at this latest mapping, Steve cleared the programs on Laynie's speech processor and had her listen to the beeps and tell him how loud they were on a scale of 1-10. 1 is barely hearing, 4 is medium soft, 6 is most comfortable (the target for conversational speech), 8 is barely tolerable, and 10 is painfully loud. So Laynie told him where to stop for each one, and then they compared electrodes to try to get the volume as consistently as possible across frequencies. Oh, and Steve was showing waaaaaaay more signing skills than he ever has. He can have a basic ASL (okay, PSE) conversation! He tries to front, but we're on to him. Laynie has been saying for a while that he seems to understand her sometimes, because he will be ready to answer before I have finished interpreting.

Anyway, that's a bit tangential. One odd thing happened at this mapping: when Steve stimulated electrode 10, it caused Laynie pain. That has not happened before. He turned off that electrode.  ?  Hopefully there's nothing seriously wrong.

The map that Laynie ended up with looked differently than the previous maps. It's kind of hard to explain.. would be much easier to draw! OK, the computer program shows the stimulation levels of the 12 electrodes as sort of a bar graph, with electrode number across the bottom and amperage (?) vertically. A higher bar equates to increased electrical stimulation. Laynie's bars used to look pretty much straight across, with a slight upward curve at the end. Now, they look the opposite! Electrode 1 is now the strongest, and electrode 12 is the weakest. But she felt like they were equally loud. I guess she does not need as much stimulation to pick up the higher frequency sounds of electrode 12. Now, it wasn't consistently decreasing with each electrode, but that was the general trend.

The reason I wanted Laynie to have a completely new map (rather than simply adjusting her previous map) was that she was having trouble discriminating speech sounds within a class, such as /m/ vs. /n/ or /l/ vs. /r/, with the exception of fricatives (s, z, sh, f, v, th). Fricatives are distinguishable based on high frequency information (i.e. over 4000 Hz), and she did well discriminating words like "sun" and "fun" or "thick" and "sick." Laynie was also struggling to discriminate low-mid frequency speech sounds of different classes, such as /m/ vs. /r/ or /b/ vs. /w/. Hopefully she'll have more luck with her new, more balanced (fingers crossed) map.

I guess that was pretty much it. He wished her luck on her second surgery. Normally she would be back to see him in three months for the next mapping (her six-month mapping), but her right implant will be activated before that. We will make the activation mapping appointments through the surgeon's office. Her right implant surgery date is July 13, barring any insurance snafus. So that implant should be activated in the middle of August.

Aren't People Funny

The people in the story I am about to tell did not look as friendly as the woman in this picture.

One afternoon, about a week after we moved to the new apartment, Laynie emailed me that someone was parked in front of our garage, so she couldn't pull in. There were a few people nearby, so she gestured and honked the horn, I guess, and they just went into the building. She ended up parking in the lot in front of the building, which has unassigned parking spots (obviously the space directly in front of our garage is assigned to us). She mentioned that it was a black car, and I thought I had seen the car before, parked in front of the garage next to ours. Laynie said that the garage next to ours had a disability services van in front of it. Suspicious, eh?

I was on my way home at the time, and when I called the apartment complex office, they gave me the phone number to have the car towed. Hmm. I decided to go home and see if I could find the car's owner before I called the towing company.

Sure enough, it was the car I had seen in front of the garage next door. A black car with Michigan plates. I thought that garage belonged to the people directly below us, so I knocked on their door. A woman bellowed, "WHO IS IT?" I waited.

The door opened to reveal several nurses: two by the door, one in the dining room, and one in the living room. Our conversation went something like this:

Me: Hi, I'm Annie, I live upstairs.

Nurse by door: Hi

(Other three nurses stare at me.)

Me: Do any of you drive a black Nissan with Michigan plates XXX-XXX?

(All four look at each other without saying anything then stare at me.)

Me: It's blocking our garage.

Nurse by door: Well, I don't know whose it is. I mean, it's not mine. (Looks at the other nurses, who shrug.)

Me: OK, I just wanted to check before the towing service gets here. Sorry to both--

Nurse in dining room, cutting me off: What kind of car did you say?

Me: A black Nissan with Michigan plates XXX-XXX.

Nurse in dining room: Oh, that's mine.

Me: It's parked in front of our garage, and you need to move it right now. I'd hate to see it get towed.

(Dining room nurse gets her keys, and I follow her out of the building.)

Punks. I could not believe she was just going to lie and leave her car blocking our garage. Please, like I'm going to take that.

As an epilogue, they have not parked in front of our garage again, even when the disability services van is parked in front of theirs (though obviously it's not "theirs," because they just work in that apartment). They do, however, give me the staredown if they are in front of the building, smoking, when I get home.

Katherine Mary Hasting, B.S.

My baby sister graduated summa cum laude from Towson University today, with a bachelor's in Deaf Studies. I am so proud of her! Katie's path to this point has been long, windy, and mostly uphill. She has finally been able to show what a truly bright person she is, and that she is capable of achieving great things. Way to go, Kate!

Star Trek

I really liked the new Star Trek movie!

The theater was nearly empty (hello, Tuesday night), which was nice. And it wasn't the kind of movie that yell-at-the-screen people attend... you know the type. There were a few chuckles at original Star Trek references, though. I don't remember much about the original series, but I guess my dad's hours of viewing somehow made an impression, because I "got" many of the jokes. For example, when Bones crooked his eyebrows and said, "Good god man!" for the first time, I cracked up. Same with his many DAMMITs. Of course, there was Chekov's accent. I love the /w/ for /v/ substitutions. Those two characters were pretty campy, actually. The Bones actor was a little too into it when he yelled, "Dammit, I'm a doctor, not a physicist!" 

The Kirk and Spock characters were GREAT. And Uhura was actually interesting, which either wasn't the case before, or I never noticed. Probably the latter. I don't know if I would have picked up on it on my own, but because someone on the radio pointed it out, I noticed how Kirk sat like a girl in the captain's chair. Legs crossed, knees together. That was like the original Kirk. But I like this Kirk waaaaaaaaay better.

Anyway, it was a good movie, and I'll definitely watch the next one.

OH, I should say that I'm impressed at how well Laynie handled the movie. She used to be so sensitive, but she didn't complain about sudden noises or anything. Luckily it was loud but not painfully loud, like movies often are. Laynie even described the bad guy's voice appropriately... wow, she noticed voice quality. She's really doing great. And she enjoyed the movie. I'm going to Netflix Star Trek IV, because I remember it being funny and interesting. But it's been at least 15 years since I've seen that movie, so hopefully it holds up.

What We Hear

Hi, Laynie. I'll try to explain what we hear by likening hearing to seeing. Picture a day at a a large county fair. 

There are lots of visual details. Can you sort it all out? Imagine you just got your sight... it would be tough to figure out what everything is. It would be too overwhelming to start with figuring out a fair, with all the colors and lights and people... You would want to begin with something simpler.

Take this plate, for example. Its shape is a circle. Focusing on the shape is like the traditional timing-based strategy, which gives you the "envelope" of a sound. It would not be possible to identify a plate without its shape. But if all you saw were a circular outline, you would need practice to know that THIS circle is a plate, other circles are DVDs, balls, coins, etc.

Does it matter what color the plate is? If you are a doctor and you just want someone to be able to recognize objects, wouldn't you choose to have them see shapes rather than colors? So does the it matter what color the plate is? I suppose that the person who made the plate would argue that its color is important. 

The color is like the frequency. As a matter of fact, color is very much like frequency... red is low and purple is high. But that's another story. Do you think you could figure out what the plate was based on shape alone? Yes. But would you enjoy looking at it more if you could see the beautiful design on it? I suspect that you would.

Your FSP processing strategy gives you timing and frequency information, which is like visual shape and color information. But you can't hear the fine gradations of frequency, which is like not being able to see slight differences in color. Suppose we see millions of colors. Suppose that you see hundreds. 

Do you remember old 8-bit computer monitors, which could produce up to 256 colors? They were limited, but they were a lot better than black and white monitors. Having some color definitely makes the viewing experience more enjoyable. Here are two images from games with 8-bit color:

Certainly, you could play those games if they had black and white graphics. It doesn't matter that the bus is green. It doesn't matter that the little spaceman is blue. It doesn't matter, but it makes it more interesting. However, could you imagine looking at these and figuring out what everything is if you had NEVER seen anything before? Take the second game, for example. You would certainly need a lot of practice to process it, especially when the little eyes start moving around and you have to control the spaceman to avoid them or shoot them. You would have to figure out what the important images were (the eyes, the spaceman, the platforms) and what the unimportant images were (the background). If you were just learning to see, you would probably find it difficult to ignore the red thing in the background. It's just always there! And it's red! That's like background noise. It's always there, and it can seem like it really stands out, but it's not important.

Here are some games with 256-bit graphics, which means millions of colors. 

Although these do not equal real vision, they are pretty darn good. Now try to imagine THESE images but with only the colors from the last images (the bus and spaceman games). That's more like what you are trying to do. Comprehend normal images with limited colors. The first one would be pretty tough. The greens might all blend together. The horse might blend in with the bridge. And the mist might make it impossible to distinguish the far-off castle. If you saw the second image but all the yellows looked the same and the reds all looks the same, etc., you might have trouble making matches and winning the game. You'd probably say to yourself, "These look the same! How do people tell them apart? They must be sighted geniuses!" But would you give up colors and go for black and white? Or shapes only? I doubt it.

Now go back to the day at the fair. It would be overwhelming if you were just learning to see and you only had the shapes plus a limited amount of colors. 100 barely-different shades of red would all look like the same red. Things might blur together. It would be exhausting to try to make sense of it all. But if you had practiced looking at different colors and shapes, when you were able to say that the horse on the carousel was definitely blue, wouldn't you be excited?

It's hard to learn to use a sense you have never really had. I guess you could say that using a hearing aid was like seeing several shades of dark red and some VERY dark orange. True, you had some color knowledge from that, but the 8-bit graphics you see now are different and probably better, when you get used to them and learn to distinguish them. If you saw something blue, you would really clue into it, because you had never seen blue before... like how you really clue into /s/.

I hope this makes sense.

Church

Our sacrament meeting was sooooo good today! A nervous youth speaker, who was dutifully praised by all who came after her, was followed by a High Council speaker, Brother Steven Towne. He gave an excellent talk about temple and missionary work. Our stake's main focus this year is on missionary work, so every High Council speaker's talk is tied to that topic. Then Summer Hill, our former Gospel Doctrine teacher sang a song that I am familiar with but cannot think of what it is called. She did a great job, and even Laynie was touched. If you know the song, please tell me the title! I'll probably try to Google the lyrics. Something about seeing him face to face... "if the world could [?] devotion..." Lots of "if..." Darn.

After Sister Hill, the bishop asked Brother Edwin Mulitalo, who was a member of the ward for eight years while he played for the Ravens but now lives in Michigan and plays for the Lions, to share his testimony. He was in town for yesterday's Faith and Football event. He briefly shared his testimony, because it was 10:00 when he stood up, and that meeting is supposed to end at 10:05. He told the story of when he proposed to his wife, traditional Samoan style, with a pile of hams, turkeys, and lava lavas in the O'Brien family living room in Atlanta, GA, to impress the family as he detailed his bloodline and qualifications as a husband. His pride in his Samoan heritage and culture was likened to his pride in his heavenly heritage and culture. I wonder if he has a book or video out. I would love to hear more from him.

Finally, one of the counselors in the Baltimore mission presidency, President McGinn, spoke. His talk was also brief, and I honestly don't remember a great deal of it. It was on missionary work, and he tried to impress upon us the importance of member missionary work, because 60% of the mission's baptisms every year for the past five years have been from member missionary work. I can't remember anything else he said. I did interpret that talk as best I could, but the noisy children around us were quite distracting. That makes it harder for me to retain what I hear, I guess. Or maybe I was still thinking about Brother Mulitalo's talk. Anyway, our sacrament meeting was great.