I hope this all in helpful. In the end, I am happy I did this and even after 2 years continue to see small improvements
Thanks for your very helpful post. Your experience is very similar to other users. It’s a journey that takes time. I am over 5 years bilateral and still learning little things. If you have difficulty with an area of understanding I have found I just need to practice more in that environment.
If you had the implant to do over would you still go with MedEl? Some of your issues are not issues with and Cochlear. Thanks
Let me write about my experiences (Cochlear CI24RE Contour Advance array and Nucleus 8 sound processor). This is not to undermine your experiences, but for showing for another potential candidates, that experiences do can differ and are highly individual depending on the lenght of rehabilitation, individual characteristics of hearing loss, etc. :
The improvement in speech understanding is dramatic and highly beneficial over HAs, esp in one on one situations. Noisy environments are still a challenge.
Indeed, main benefits are in 1:1 situations, however I remember that there is user in this forum, who can hear someone quite distanced in the pub (IIRC, on the another side of table). However, it should be keeping in mind that he probably used automatic SCAN2 program, which uses aggressive noise reduction and very strong directionality (ForwardFocus with strong beamforming).
Music appreciation is NOT improved. It is changed. I find there is significant distortion of music, enough so that without the benefit of my HA in the other ear, I might not even recognize pieces I have known for years. I am still working on why and it may be due to the filters intended to serve as noise reduction.
Another highly individual issue. Yes, listening music by only is poorer than through only my better ear with even when I use streaming. However:
I can recognise pieces I know by CI only (that was very hard at the beginning of rehabilitation, but now it is much easier)
when I listen to music bimodally, the music is definitely better than by HA on the better ear only. Music is louder and fuller and experiences are also much better, music started to have pleasant pervasive attribute and be goosebumping more often.
Other sounds (birds, wind, etc) are also very much improved. Without my CI I could not hear any of these.
Agree. Although with new Phonak Audeo Infinio Sphere 90 I started to perceive birds much better through HA only, the most sound power goes through CI system.
Don’t be afraid to experiment with your audiologist, esp early on. I did anatomy based fitting where the CT scan measured the exact location of each electrode and the mapping was set to the frequency of those locations. I find the pitch match my unaided ear.
Streaming. Med-El claims that any BT enabled HA can be paired with their CI. While that is true (it took a little effort to get this done), there is a latency difference that I have discovered is associated with the protocol used to transmit signals. The CI comes first then the HA. The effect is enough lag to make understanding very difficult. They get around this with a streamer and this works reasonably well
I’ll try to find a post with a short video on YouTube that may solve the problem.
Unfortunately unlike glasses or cars, no one has the ability to tryout a and decide what works best for them. That said, I am not disappointed with the overall results or the support from ME during the process. My 2 small disappointments are the quality of music and the quality of streaming. I understand the music issue since all CI manufacturers are focused on maximizing speech comprehension, a need we have 24/7. As for streaming, I am certain it will improve as they introduce new software and hardware. But as someone once told me, these are medical device manufacturers trying to learn software, not the reverse.
Agree. Although with new Phonak Audeo Infinio Sphere 90 I started to perceive birds much better through HA only, the most sound power goes through CI system.
Birds, crickets and some phones are generally high frequency sound generators. If you look at my , you will see I have little hearing above 500 Hz. You do. Amplification in that range accomplishes nothing for me. It will for you. My hearing in that range is excellent and my brain fills out the other side.
I’ll try to find a post with a short video on YouTube that may solve the problem.
As a user, I am using devices from 2 different manufacturers, so signal processing speeds can differ. I first discovered this when trying to stream music. It sounded like 2 conversations overlapping. Because of the complex sopund profile (speech or music) I couldn’t tell which was faster. Doing a little research, I found a website with a latency tester ( Latency Tester2 ). When listening to the pulse either each ear separately or together with or without or CI, the pulse is a single beat. When streamed you will clearly hear 2 beats with the CI first.
I brought this to ME’s attention and they confirmed that even with the protocol for low energy bluetooth (), the signal reaches the CI first and then the HA. Their “fix” temporarily is a streamer that sends the signal to both via . That in fact works, but is cumbersome.
I would be very interested in learning if other bimodal users with different equipment have the same experience when running the test.
No need for secondary devices is another. I did read that MedEl will stream with iOS without a secondary device. If that’s true that’s a big step forward for MedEl.
What I have experienced so far after 2 years is that is I stream via the louder of the 2 receivers (the ) dominates and my brain tries to minimize the later signal. I actually find it easier to simply take out my in those cases.
Maybe I wasn’t clear. I have a Widex Moment (new since my implant). I am able to pair, connect and stream to both together. However since the signal does not reach each at the same time, I hear 2 signals offset by 300ms. That’s enough to create the perception overlapping sound. It works, but it isn’t useful.
I would be curious to learn of your streaming experience. What processor do you have and what do you use? Can you stream directly them via your phone, computer, Ipod, TV, etc? If so can you run the test I provided and tell me if the beat is 1 or 2.
However since the BT signal does not reach each at the same time, I hear 2 signals offset by 300ms. That’s enough to create the perception overlapping sound. It works, but it isn’t useful.
I thought MedEl had a secondary device for this issue???
What CI processor do you have and what HA do you use?
I am bilateral . I do not use a secondary device to stream. I use an Android Pixel 9 that is compatible with the processors so no need for secondary device. There is zero delay or lapse between the processors. Cochlear and do not need secondary devices to stream without any sound delays with bilateral processors or with compatible aid.
@Dani uses MedEl. Maybe he can share some info about streaming.
All companies can stream for bilateral users without issue including MedEl. It’s users (CI and ) that creates the issues. is owned by a company that owns Phonak and they work together. MedEl has the ability to stream to two different devices, but latency differences makes its less than optimal. The separate device solve this and is used ONLY for use with 2 different devices. I am sure this will change with new software and the introduction of .
You can stream from any device that supports . Its not just phones, but can include iPods, computers, even TVs, especially newer ones. Some devices are more sophisticated and can show what is paired or connected. Phones can do this nicely, but TVs can too. I have a Samsung S23 and can connect even 3 devices at the same time including my and .
This is why bilateral is ok but is not, correct? MedEl doesn’t have a compatible smart phone. That’s where the secondary MedEl device is needed to properly stream to the aid and processor. Am I catching on now?
Very interesting link about latency. I tested it, but I can’t test it bimodally now without intermediary device (Cochlear Phone Clip). Streaming directly to sound processor can’t be joined with streaming to in the same time:
By only:
By HA only (Phonak Audeo Infinio Sphere 90 Bluetooth Classic):
By smartphone loudspeaker listening bimodally:
However, I found that that test is influenced by delaying first tap since start. That note is important, because waiting for beat causes temporary streaming disconnection to the sound processor. The I have to press volume button to reconnect streaming.
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