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My 3rd Cochlear Clinician,
Fairhope, AL

1563 words


The following is a memoir of my cochlear treatment experience and my personal evaluation of this healthcare provider based on a witness and my journal documentation.

I asked this cochlear clinician to lower volume on frequencies above voice register. After five months of dawdling he only reduced the shriek to a screech, then abruptly cut me off with a curt email.


After a perfunctory cochlear "audiologist" left me with a sound processor that shrieked exasperatingly, I spent several weeks hunting before I got an appointment in early October 2021 at Gulf Coast Hearing Clinic in Fairhope (False Hope??), Alabama.

The private owner, Dr. Randy Tubb, a bald headed fellow with an exaggerated Army officer air about him, claimed to be more patient oriented since he was not beholden to a hospital, university, or other supervising institution. I asked if he would reduce the volume of my shrieking frequencies on the first visit and he said he would.

At the appointment, my wife and I explained the wham-bam-preset-slam  style of programming my previous clownician did so badly.

"There's a lot of perfunctory out there," Dr. Randy said, confirming my suspicion of my previous quack and causing me to wonder how many more were like that.

He reduced only slightly the very high frequency (6000-8000 Hz range) loudness, but it was not nearly enough as the shriek became only less jarring. He showed no knowledge of the cause of the shriek and even said so.

Then he spent time cleaning my hearing aid, changing the microphone cover on my sound processor, and showing my wife how to use the Cochlear collar-clip microphone accessory to speak to me from a distant room, which was very nice. But with the sound processor programming so badly screwed up, the clip-nic would merely stream shrieky unintelligible speech, and did not fix the shrieking processor

"Try this for three months," he said. Oh crap, I thought. He doesn't know what to do. I have to try to figure it out myself… again.

He obviously dismissed my claim of a loud "shriek" assuming it to be merely a little noise. He briefly touched on the usual snake oil slogans about learning to listen electronically, and it won't sound like normal speech, etc. The answer seemed clear that I will never get this fixed again. Once home, I quickly saw that the adjustment was far too inadequate. View Dr. TeenieWeanie's adjustment tech. My wife called for another appointment in early…


November


This second visit was not good. Adjustments downward of the high 4k+8k Hz did not yield reduced high amplitude. Mr. Tibb did not have answers. He gave me 4 MAPs of 4 programs to compare, the one from the previous gonzo clinician which was stored in the processor (surprising discovery for me) and three of his own cobbled derivatives. As with my 1st clinician, I was to choose the one I liked best and accept it. But they all SUCKED! And shrieked because upper frequencies were raised too loud. But he just refused to hear that!

He made a point of telling me the sound processor programming software has many limitations. He said that he had 20 cochlear patients. Three were content. seventeen called their devices "little better than nothing at all." I would soon learn that Dr. Randy's knowledge and skills were also little better than nothing at all. This man couldn't MAP his own back porch if you measured it for him.

"Doctor, I don't mean to sound rude," I began. "But before I got this head gadget, I was an award-winning digital audio recording engineer, sitting between better pro-audio loudspeakers than you've ever seen. I was adjusting and balancing more varieties of sounds than you ever had time to hear. I can hear what you do immediately and be fully adapted within 48 hours. I don't need three months to identify that if foot shuffling shrieks, that means that some C-levels above 300 Hz are TOO DAMN HIGH (LOUD)."

In a nod to my audio background, he made MAP printouts of the four programs. "You didn't get these from me!" he said, confirming that most audiologists hide stuff.

He also gave me a photocopy of the Cochlear Americas' Custom Sound 48 page software manual, saying that if I read this, I would understand the limitations of the sound processor, adding "you did not get this from me, either."

His intention was clear enough. I was expected to read it and understand processor's limitation. But the MAPs and manual showed mehelped me understand the limitations of some or many audiologists' programming abilities.

I immediately saw that this little 48 page booklet was nowhere near as complex as the the 1000 page manual for the computer recording software I worked with for Tje20 years. But it did explain what technology was inside my processor.

The 4 MAP printouts readily confirmed what I was hearing. I discovered high loud C-levels between Formants F1 and F2 in all four programs! And there were high loud C0levels above those frequencies. No wonder my sound processor shrieked with every noise. The amplitudes of the electrodes were way out of whack.

Dr.Randy should have seen this. But he didn't. Why not? Could he not interpret his own MAPs? What else did he not see or know?

While at home, with the highest frequency volumes now turned down, I used a tone generator to search for the loud spot of the shriek. It appeared centered on 1440 Hz. That was right in the F2 Formant region. So, my audio experience suggested that the high current levels between F1 and F2 was causing the loud spike at F2. Reducing the gain of those current levels should lower the spike and suppress the shriek. But how much?  Well, lower some and find out, of course.

I had dealt with a similar condition with my 1st clinician and thus learned thought was correct. But when I finally got an appointment, two months later, it proved horrendously difficult to get this man to lower the current levels I requested.

I was "fit to be tied." How many months and appointments would it take to GET IT RIGHT?  I was beginning to understand how many people had probably been failed by this and other weak audiologists. By now, I had heard about many who just gave up and put their devices om a bottom  drawer.

January 2022

At this session, an additional problem centered around Dr. Randy's "admission" that I had "challenged his knowledge." He told my wife that he had NEVER had a patient with my level of background in sound. I didn't care. Attenuate the upper range loud C-level loud spots and reduce the shriek so I can hear words. Why is that so hard for you ear doctors to understand?

I explained that the formants F1 (500 Hz) and F2 (1500 Hz) were way too loud. He said he didn't know what those were! I was shocked! How could this doc get through audiology school without training in these essential speech formants? He is expected to know this stuff.

Desperate to get fixed, I "taught" him and showed him the MAPs he printed.

Well, he diddled and dawdled but did not reduce the numbers sufficiently. I asked him to lower them some more. He hesitated and asked more questions about the shriek. I gave him a perfect description and even  specified which channels to make softer. He said he "didn't know what to do" and "what does it sound like?"

I could have gone to a healer televangelist like Peter Popup or a candy striper from a local hospital for the same outcome.

Finally, he set up the computer and began reducing CLs. Then he crashed his computer. We began again. He reduced numbers in my selected MAP. But then Dr. Randy DIDN'T SAVE THE MAP! It had skewed and was now worse than before.

But I STILL had to wait until February to get Dr. Debacle to fix this. This was destroying my work life and putting tensions on my poor wife.Meanwhile, he was billing my insurances for his failing work.

February

It is now the 5th month. This bungler had made no lprogress in suppressing this shriek. He has not diagnosed it. *I* diagnosed it. But now he finally lowered the current levels between F1 & F2 and the shriek was immediately reduced to a screech. What it now revealed was a loud, previously masked, harsh region between 2k-4k Hz. This also needed to be reduced.

But the doc threw up his hands at this. He was upset that I didn't get it perfect on the first guess? After months of his fruitless frequency juggling? But now he screwed up a couple other things. We made a March appointment.

Within a week, I had analyzed the MAP and estimated settings that could likely be closer to workable.

Two days before the March appointment,
Dr. Randy Tubb emailed that he was no longer able to help me and I had to find another provider. Evidently he was not about to let be get fixed.and would readily withhold treatment.

Yes, I was livid with this dirty twiddle-bitch! He fixed nothing after grifting on my insurances for five months and further ruining my life.


Winfield Rothlisberger, MM, JD, PhD


Now, imagine what THIS doctor could do for your cochlear implant! time after time!

Dr.Randy Tubb  d



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