In this blog post, Professor Pete Thomas describes how he and his wife use accessories alongside their hearing aids to help them enjoy playing in a brass band.
Despite being branded as tone deaf in schooldays, and suffering from moderate hearing loss too, seven years ago I started to play trombone. Now, aged 69, I play in a brass band. My wife, Carol, a lifelong musician who plays euphonium is afflicted with a severe hearing loss as well, a long term condition combined with severe tinnitus.
Playing music in a brass band presents a range of challenges for hearing aid users. Some opt in despair to abandon aids and make do with whatever residual hearing they have, or else to give up playing altogether. Sound levels may exceed 105dBA, although this can depend on seating position within the band, and most hearing aids do not work well in these conditions.
Players should be able to clearly hear neighbouring players, so as to be able to play in time and in tune with one another. They also need to hear other sections of the band to effect the overall tuning and timing of the music. As a trombone player, I need to be able to hear euphonium and baritone horns immediately in front, to perceive the higher pitched sounds of the cornets from the far side of the band, to be aware of the horns, all whilst not forgetting the basses (tubas) which are hard to ignore. And in rehearsal, it is important of course to hear the instructions from the conductor!
For me, playing without hearing aids is not a realistic option. With my high frequency loss, I am barely aware of the cornet sounds and much of the articulation is lost. The resultant dead and rather woolly musical environment, with no perception of commands from the conductor would preclude participation.
My aids were initially prescribed following diagnosis/treatment for benign positional vertigo; as a result the world became a more interesting place where many of the sounds diminished over the years were reinforced. Percussive sounds and cornet sounds became so much clearer and more vibrant.
However, with those first digital aids there was a major drawback. When the cornets played certain higher notes, this tended to excite feedback cancellation in the aids and it seemed as though some of the feature recognition aspects of those aids distorted the balance of the sound. Exploring this, I found that even on what was supposed to be the music setting, if I sat at home listening to my wife playing the piano, the ticking clock which is normally barely perceptible, would become a loud clacking, clearly audible above the piano. The squealing with the cornets was clearly a problem, especially as when it occurred it would take some considerable time for the aids to settle back to normal operation. I found the condition could be repeated in a quiet environment with a tone generator – a tone of approximately 2KHz from a loudspeaker would trigger it. I discussed the problem with audiologists who attempted changes of settings, changed ear moulds and generally puzzled over the problem, before concluding I was seeking the impossible.
Fortunately I encountered a more determined audiologist who appreciated the objective feedback and wanted to be of help. She prescribed some alternative aids for evaluation and following some adjustments they have proved remarkably effective. Initially, things were very confusing, as each aid made my custom-made trombone sound rather different and unpleasant to my ears. Fortunately, this was a transient situation as my brain adapted to the different hearing aids and within a few days I could switch between aids without any unpleasant perception of the sound. The new aids, whilst providing the necessary high frequency compensation, appeared less intrusive, such that apart from the useful improvement in music and comprehension of speech, I could be unaware of using them. Most importantly they were far less susceptible to excitement from those higher pitched cornet sounds!
Initially the aids were sometimes apparently overloaded by the mellow tones of the euphonium, but presumably due to the adaptive capabilities of the aids, even this problem rapidly diminished. The aids are not perfect and I will sometimes query as to whether the conductor wants to play from rehearsal mark ‘M’ or ‘N’, and it can be frustrating to miss out on the punch line of jokes from around the band. This leads on to the consideration of Carol’s more challenging problems of playing the euphonium.
Carol has played church pipe organ and piano since childhood, but during the last three or four years she has succumbed to pressure to join the band, playing a euphonium. The expectation was that this would be easy for someone of her musical experience, but with brass band pitch being transposed from concert pitch such that notes written as C sound as B-flat, there were additional challenges for her hearing. The single line of euphonium music might have paled into insignificance compared to the complexities of the Bach and Buxtehude, with pedals and multiple manuals to cope with; however in the brass band there is someone else (the conductor) setting the tempo and all those other players to fit in with.
Carol uses two Phonak Nathos SP aids with features such as the frequency translation of higher pitched sounds, enabling her to comprehend some of those missing high frequency sounds. Early experience with these aids suggested that she had trouble precisely pitching and playing in tune and this was particularly evident if playing in a small ensemble. Fortunately, the enabling of a music program, disabling some features of the aids, made a dramatic difference and in the small ensemble she was able to play far more reliably in tune. However, in band a major problem unfolded whereby when playing her euphonium, especially when accompanied by a neighbouring euphonium, she could hear virtually nothing of the rest of the band. This problem intrigued me and I set about trying to find why the euphonium was so troublesome!
All brass instruments have characteristic spectral properties, whereby the fundamental of a note with a particular set of overtones gives the instrument its sound. The different instruments differ in size (from the tiny soprano cornet to the large B-flat tuba) and in construction with the size and degree of taper in the bore. The trombone is a parallel bore instrument, and this reflects in the sound which is rich in overtones – the FFT analysis here shows peaks extending to the 15th or even 20th harmonic of the note being played. Curiously, the trombone can seemingly be very light on the fundamental of the note being played. In contrast, the euphonium with its taper bore is very strong in the fundamental, with the overtones rapidly dying away. The similarly pitched baritone horn with a less tapered bore has a spectrum more like that of the trombone.
It is therefore no surprise when my wife encountered the problem with the euphonium and the musical director of the band suggested trying the baritone horn for a while, that Carol found this a great benefit. This enabled her to play in the band and still hear much of the music from other sections of the band. However it did not help with hearing direction from the conductor.
We therefore looked into the potential use of a microphone and loop system. Whilst this could have worked within the band room, it was clearly not a practical solution for performance venues. It was around this time we discovered the Phonak Roger pen system. Initial enquiries with a supplier were far from optimistic of its utility, but discussion with CamTAD suggested it might be worth further exploration. With a musical director keen to cooperate, a microphone and receivers were sourced. With Carol’s severe high frequency hearing loss, the bandwidth limitations of the telecoil loop interface was not seen to be a problem compared to the convenience of implementation without assistance from the NHS audiologist. However with my helpful NHS audiologist happy to enable such things we got some Roger receivers for my aids in the hope they might be a benefit.
The Roger pen proved to be a major benefit for Carol. She was able to clearly hear instruction from the musical director (wearing the microphone) and as a bonus could hear more of the cornet section music, which often provided the lead in the music. Somewhat disappointingly, we found that although I could hear the conductor more clearly with the microphone, due to the bandwidth limitations of the Roger pen and my open ear moulds, I perceived the rather tinny overlay of music rather unhelpful even with the wireless receivers giving direct audio to my aids. However I have at times found the mixed mode of normal aids and the Roger input useful. The wider benefits of the Roger pen are obvious.
Recently with more experience, Carol has been returned to playing euphonium. We have to conclude that from our experience, hearing aids and appropriate accessories can be a real benefit and enable hearing impaired users to successfully participate within a brass band. The recent HAFM conference at Leeds inspires us for further work.