One thing I have been meaning to announce on this blog is at the end of the month I will be getting a cochlear implant. This is a pretty big decision. I’m still pretty nervous about it, but excited too.
A cochlear implant (CI) is a surgical procedure when they put a special electrode in your cochlea. The cochlea is the snail shaped thing inside your ear that sends the information to the brain. In a normal cochlea, sound causes little hairs to move and that movement sends information over nerves to the brain.
For more information see this website:
http://hearingloss.org/content/cochlear-implants
and Wikipedia actually has some good images though I haven’t had a chance to actually read all the text:
http://en.wikipedia.org/wiki/Cochlear_implant
For someone like me with sensory-neuro hearing loss, the hairs in the cochlea don’t work very well and only respond to extremely loud sounds like those produced by a hearing aid. Unfortunately, no matter how loud the hearing aid is, there’s till gaps in the quality of the sound which make it hard for me to understand speech. I rely a lot on speech reading (aka lip reading) to understand what people say. If I can’t see the other person’s face or there’s too much background noise, I often have no idea of what they are saying. They might as well be one of the teachers in the Charlie Brown cartoons.
The implant actually has two major parts. The electrode in the cochlea is connected to a magnetic disc that lays just under the skin behind your ear. A speech processor with a microphone sits on your ear just like a hearing aid. But instead of connecting to an ear mold to send sound into your ear, it has a short cable that ends in a magnetic disk that sits on top of the other magnet under the skin. The processor sends information through your skin to the implant which stimulates the cochlea which then sends the signal to your brain.
There’s no wires or anything sticking through the skin, but they do have do drill a hole in your skull and thread the implant into your cochlea. They also shave down a circle in the bone of the skull behind your ear so that the round disk part can rest in the depression right under your skin.
A CI can dramatically improve speech comprehension for someone at my level of hearing loss, but it’s a pretty major decision. While it’s pretty low risk surgery, they will be drilling a hole in my skill and it takes about a month for that to heal up. Also, you can’t undo the surgery. Second, in most cases, inserting the electrode will destroy whatever hairs and residual hearing are left in the cochlea. For someone who’s completely deaf in that ear, that’s not much of a concern. But in my case I still get some benefit from hearing aids, so it makes me a little nervous to give that up. After the surgery, that ear will be completely deaf unless the processor is turned on. Third, the sound you get with an implant is different. It takes a while (up to a year) for the brain to get used to it. Fourth, while speech comprehension usually improves dramatically within a few month, music may not sound right any more.
So for a long time, an implant was something that I would have considered only if I lost all hearing in one of my ears. It’s not easy being hard-of-hearing, especially with a loss as severe as mine. But I’ve been at the same level for a long time, so it’s familiar to me. There was also the fact that I didn’t know anyone with an implant.
But when I started attending Hearing Loss Association meetings, I meet a lot of people with implants who were very happy with them. Then a friend in the neighborhood with hearing loss similar to mine went ahead with the implant. Learning from his experiences helped me feel much more comfortable with the idea of going ahead with the surgery.
But it’s important for me to keep my expectations realistic. First of all, even in the best possible outcome I still wouldn’t have normal hearing. It would be much better than what I have now, but I would still need to rely on speech reading in some situations, and noisy environments will still be very challenging. CI’s aren’t a magic cure, but they offer a dramatic improvement over hearing aids.
Second, it takes time and effort to get the most benefit from the implant. I have to wait a month to heal from the surgery before they activate it. Once they activate the implant, it takes a while for the brain to get used to the new signal, so at first my hearing may actually be worse. But over time the brain gets used to the implant and the audiologist adjust the program on the processor. They recommend doing some kind of rehab such as audio books, starting with simple kids books to give you practice. But some people say even after you’re used to the implant, it can be tiring listening to speech.
Many people hope for a “rockstar” activation where they are able to understand speech right away. I’m trying to keep my expectations low. I think it would actually be kind of cool if at first all I hear is strange robot sounds. I’m hoping if I keep an open mind and a sense of humor the process will be fun rather than stressful.
It’s a scary decision, but I think it’s the right one for me. Over the years I have tried a lot of different strategies and gadgets. I have taken sign classes and gotten more involved with both the deaf and the hard of hearing community. I don’t mind wearing hearing aids, but it’s still frustrating missing so much of what’s going on around me. I think that the improved speech comprehension of the implant will help me both professionally and in my overall life. Being a husband and a parent isn’t easy for anyone. But it’s hard on everyone when you’re constantly unsure of what others in your family are saying.
I know that many Deaf people are happy the way they are and are not interested in getting implants. I certainly respect that. But as someone who grew up and still lives primarily in the hearing world, I think this is the best decision for me.
Faded Epiphanies 