An Octogenarian’s CI Journey
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Part 5. The Activation

Posted By Naama Tsach, PhD, Monday, April 23, 2018


 

For the next month I was effectively deaf. At first I was afraid to go out. Finally I decided that was silly and started resuming normal activities. I decided to be assertive and told sales clerks and other people that I was deaf. One clerk said “But you could hear me just then.” I replied that I was deaf, but not quite deaf as a stone. She looked at me with a puzzled expression.

A month after surgery my head and ear had healed up. Activation day had arrived! At the clinic I was introduced to another audiologist, who was waiting with a room full of equipment. She showed me the sound processor. It looks somewhat like a large hearing aid. Attached to the processor was a short cord, and at the other end of the cord was a circular coil about an inch in diameter. Embedded in the middle of the coil was a small magnet. The coil and magnet are the interface to the internal implant, which also has a magnet, and was inserted in the mastoid bone of my head during surgery.

Hearing Sound Through the CI for the First Time
The audiologist hooked the processor up to her computer and I put it on my ear. So far, so good. After several unsuccessful attempts, I was able to place the coil in the correct place to connect with the magnet that had been placed inside my head during surgery. I let go of the coil and it stayed on my head, held gently but securely by the magnets, one internal and one external. I heard sounds through the cochlear implant for the first time. It worked! Something was coming through, but it wasn’t anything I could understand. All I heard was noise—loud, muddy, and garbled.

Programming the Processor for Me
She turned off the sound. We were ready to “map” the cochlear implant. The implant has 22 channels meaning that there are 22 different tones that needed to be programmed (or mapped). With my processor connected to her computer, she played a pure tone that corresponded to one of the channels. For each tone I indicated to her three things: when the tone was too loud, when it was too soft, and—like Goldilocks—when it was just right. When all 22 channels were mapped she played them back to me through the computer one at a time. This sounded like a strange chromatic scale. I told her that one tone was too loud. After a few tries, she found the noisy tone and reduced its volume.

She pressed some keys on her computer and said, “I’m going to turn it on.” Immediately my head was filled with a cacophony of noise as all 22 channels played simultaneously. It sounded like two chimpanzees banging aimlessly and loudly on two pianos. I sat there for a few seconds trying to make sense out of all this and wondering if I would ever understand anything. Suddenly, through all this confusion, I heard the audiologist asking, “Can you hear me?”

Making Sense of the New Sound
Yes, I heard her but not very well. It sounded “muddy” and strange. But I heard enough to figure out what she had said. I turned to Joy and asked her to say something. She said a few words. I heard her. It barely sounded like Joy, but I could make out what she was saying. The chimpanzees were still making a racket, but it was somewhat softer and not quite as confusing. I reflected on the fact that the sound I was hearing started out as sound waves. The external processor converted the sound to electrical impulses and sent them through the coil to the internal implant. The implant in turn sent the sounds through the cochlea to the hearing nerve in my brain, and I heard sound.

The first audiologist came in and asked how it was going. I could understand her, mostly. Every small environmental noise came through very loudly. A piece of paper rustling on the desk sounded like a hurricane. The air conditioning vent made a loud “whoosh” noise. Through this racket I could hear, faintly, what sounded like voices. And I could understand some of the words these voices were saying.

As I continued to get adjusted, we picked out accessories for my system. The most important one was a small controller that fit on my pocket that I could use to change programs and volume. Another was a tiny microphone to place on a table or clip to a speaker’s lapel. It was my own private broadcast system, going to my ear only.

They installed four programs, ranging from very loud to very soft, on the processor and controller for me to try out. We made an appointment for the following week to fine-tune the programs.

I had an appointment with the doctor in about 90 minutes so we left for lunch. I was eager to see how my new hearing worked in public. We picked a cafeteria-style restaurant. It was noisy and confusing with numerous conversations of people coming and going, orders shouted out, the loud high-pitched clash of silverware, and trays slammed against the trash bins. All I could understand were occasional snippets of conversation.

Activation was Exhausting!
After lunch we returned for my doctor’s appointment. To my surprise, I heard and understood him with little difficulty. He sounded like a little tiny voice whispering in my ear over all the background noise. But, I told him, both Joy’s and Amy’s voices came through garbled. He said that I wasn’t used to hearing his voice so my brain did not have to get used to hearing it with the implant. But their voices were familiar and I had to get used to the way they sounded with the CI. He examined my ears and the incision and found everything was okay. I should go home and take a nap, he said, because my brain was working hard to adjust and it was very tiring.

This was good advice. We got in the car and left for home. I soon fell asleep.

Bruce Sloane, M.S., M.A.

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Tags:  cochlear implant activation  listening with a cochlear implant 

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Robin Ryan says...
Posted Monday, April 30, 2018
This is very great information. I am interested in reaching Mr. Sloane. My husband and I are trying to decide about CI for him (complete nerve deafness on the right with no cochlea due to surgery - not a candidate for CI). Severe worsening nerve deafness on the left - worsening weekly in the last month due to treatment for acoustic neuroma. Still has a functioning cochlea. Trying to make a decision. Would love more information from Mr. Sloane about Part 6! (What were the steps after activation, and how soon were you happy with the results?) Please feel free to reach out to me with contact info if he (or anyone else with similar experience) is willing to start an email conversation.
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The mission of the American Cochlear Implant (ACI) Alliance is to advance access to the gift of hearing provided by cochlear implantation through research, advocacy and awareness.