An Octogenarian’s CI Journey
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We are pleased to share Bruce Sloane's blog, An Octogenarian’s CI Journey, detailing his passage to improve his quality of life with a cochlear implant. His story began more than thirty years ago when he noticed a change in his hearing. It is typical of an adult who has progressive hearing loss. He was fit with his first hearing aids. He continued to experience loss of hearing acuity. As his hearing deteriorated, he experienced further changes in his ability to communicate in various settings. He was fit with stronger hearing aids with limited benefit. Finally, a turning point occurred that helped him move forward his decision for a CI—thanks to an accidental meeting with a CI recipient in a supermarket. This meeting changed the course of his hearing loss journey dramatically. The blog will focus on Bruce's decision to pursue a cochlear implant, the medical and audiological evaluations, the surgery, and the early outcomes. Please join us in following Bruce’s warm-hearted story.


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Top tags: Cochlear Implant Activation  listening with a cochlear implant  cochlear implant benefits  cochlear implant candidate  cochlear implant evaluation  cochlear implant process  Cochlear Implant Surgery  how to get a cochlear implant  steps to a cochlear implant 

Introduction to Bruce’s Final Post

Posted By Naama Tsach, PhD, Monday, September 24, 2018
Eighteen-months post-implantation, Bruce Sloane is giving us a point in time window into his life by sharing his experiences and his achievements as well as important improvements in his quality of life. His energy is now focused on helping others who are going through a similar path by advocating, writing, and teaching. We are excited about his forthcoming e-book that will further expand opportunities for others to learn from his story. We are also grateful that he will include American Cochlear Implant Alliance as a resource.

Thank you, dear Bruce, for being so generous. We enjoyed working with you and we were touched by your writing. We are grateful that you allowed us to accompany you on your journey and witness your special spirit. Your journey inspired us and so many of our readers.

Wishing you all the best,
Naama and Donna

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Postscript: 18 Months Later

Posted By Naama Tsach, PhD, Monday, September 24, 2018
I started writing this narrative about a year ago and am now finishing with these last few paragraphs. What is there left to say? Is my hearing now “normal?” No, but it definitely is “near-normal.” I manage to hear in almost any environment. At a large gathering last week, I enjoyed a coherent discussion with a friend, despite the numerous noisy conversations going on around us. We were both close to shouting and struggling to hear. She knew how meager my hearing was before the CI. During a lull, she said, “A year ago we couldn’t have had this conversation.” How astute, and how true.

I can still talk loudly (and do at times), but now I speak mostly in such a low voice that some people ask me to talk louder. Shrill voices are sometimes hard to understand, both on TV and the phone but it’s simple enough to adjust with the CI’s remote control. I enjoy the rapid pace of a heated discussion or argument even if I occasionally miss a word or two. And I continue to be amazed by the sounds of nature; when I step out the door each morning I listen to the tweets—the birds’, of course, not that other kind—but where the birds are located exactly is difficult because my directional hearing is still poor.

Helping others who struggle with a hearing loss is important to me. My audiologist has referred me to several people who have recently lost their hearing or are having problems. I’m happy to share my experiences and answer their questions, usually through e-mail. In addition to communicating via this blog, I’ve talked to community groups about hearing loss and written several articles about cochlear implants. I was looking forward to teaching a short course about hearing as part of our community’s adult education program but not enough people signed up and the course was cancelled—maybe next time.

Hearing technology continues to advance. Many CI recipients use hearing aids or have usable hearing in their contralateral ear. The three major cochlear implant manufacturers are now considering hearing aids for the other ear as part of the hearing equation. Depending upon a person’s hearing characteristics, this can enhance the hearing experience in important ways—including helping with directional hearing. Hybrid or electro-acoustic devices that combine “electric” hearing with acoustic hearing are an option for some.

Insurance coverage is evolving for technologies beyond the straight cochlear implant. Your CI clinic and the cochlear implant manufacturers’ insurance support offices can assist.

Visit the ACI Alliance insurance page to take advantage of a wealth of information there. On this page you can read about other folks’ experiences and also see what the experts recommend on insurance coverage issues. You can also send questions to the ACI Alliance staff to post or respond to. I’ll add my comments as I thread my way through the process.

I hope to release this entire blog soon as an enhanced e-book, downloadable to a Kindle or other e-reader. When it’s ready, I’ll announce it here. Stay tuned! I hope you have enjoyed reading about my journey and it has been of value to you. Best wishes, and happy hearing!

Bruce Sloane
The Octogenarian

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Part 7. Two Months Post Activation

Posted By Naama Tsach, PhD, Wednesday, August 15, 2018
Updated: Monday, August 13, 2018

At our next visit the audiologist and I agreed that the hybrid system was not helping. Apparently even though I had some residual low-frequency hearing, there was not enough for the hearing aid to help. But we both felt that it had been worth trying, and I encourage everyone to give this a trial if your cochlear implant audiologist thinks it might help.

The audiologist made a few changes in the programming. As with previous changes, some programs initially seemed excessively loud, but became more normal as time went on. The two new ones installed in this session were considerably louder (but clearer) to me than the one from the original mapping.

Two months after activation, I have reached several milestones. Most obvious is that, in almost all situations, I can hear and converse almost normally. Occasionally I miss a word, but—as I carefully observed—so does almost everybody. When I don’t understand something, instead of just saying “What?” I’ll try to put the question in context. (“You say you visited where?” “Was it Barbara or Barry who got lost?”) Things aren’t perfect, but it sure is a vast improvement. Joy and I are conversing easily, and she says, she feels more relaxed and at ease. We both feel closer to each other than we have in years. That alone has made it worthwhile.

I am much more active in groups and social gatherings. I can join in most meetings and discussion. I hear what they are saying. I am losing my reputation as “the guy who just sat there.” Some friends and acquaintances are curious about the implant and ask numerous questions, which I am glad to answer. Others take it more matter of fact and ignore it, or say something like, “Hey, you hear pretty good with that thing.” I’m happy either way. Others tell me that I talk in a softer tone than before and no longer shout.

Over the years I’ve often felt that Joy made friends and had more friends than I do. I’ve felt she was just more socially adept than I am. Recently I’ve noticed some subtle changes. Friends who used to direct their talk primarily to Joy are now speaking directly to both of us. Two friends, who used to look only at Joy as we talked, are now looking at and making more eye contact with me.

I was worried that without the CI I wouldn’t be able hear Joy at all. But if we stand close to each other and she talks into my “good” ear, we can manage—no lengthy discussions, but at least we can communicate. Talking on the telephone merits just a barely passing grade. Sometimes I listen via the contralateral (non-CI) ear; other times I use the implanted ear. I can manage almost all phone calls except for cell phones with poor connections, which seem to be a problem for a lot of people. Some music sounds pleasant, especially something with a strong beat; other music sounds like so much noise. Directional hearing is poor. I can’t tell if sound is coming from the left, right, in front, or behind me. I’m not sure if this will ever improve. Sounds of nature keep getting better and are still amazing. I never realized that the creek and the wind could have so many different voices and tones.

Bruce Sloan, M.S., M.A.

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Part 6. The First Few Weeks

Posted By Naama Tsach, PhD, Monday, June 4, 2018


Getting Started with My New Hearing
The next morning I was eager to try out my implant. When I put it on, it took me a few seconds to find the right spot on my head to attach the coil. As soon as I did, I was flooded with a variety of ambient background sounds including my own footsteps, the extreme loud jingle of the dog’s tags, and a low-pitched humming that I later found out was the refrigerator.

Hearing a Black-Capped Chickadee
I went outside and heard birds singing. Where did all these birds come from? I recognized one song as that of a black-capped chickadee. I was amazed that I heard any birds at all, but the fact that I recognized the exact bird call was astounding. How many years had it been since I last heard that? I walked down to the creek and listened as the water splashed and gurgled over the rocks. Before, with hearing aids, I could faintly hear the water, but now it sounded louder, richer, and almost musical—a happy-sounding creek. I also heard other birds that I couldn’t identify.

Hearing Voices
I went in and greeted Joy. Her voice sounded loud but distant and mostly understandable. It was almost as if I was hearing two voices at once: Joy’s usual voice as it always was, but louder and easier to understand, and a little tiny voice of Joy’s that seemed to be whispering in my ear. That feeling of hearing two voices when people spoke—a more-or-less “normal” voice, plus the “whispering-in-my-ear” voice—persisted for several weeks. I was still wearing a regular hearing aid in the other ear, but the sounds that came through the implant always seemed louder, even if they were garbled and harder to understand. Paradoxically, outside sounds—birds, wind, running water—seemed as natural as I had ever remembered.

I turned on the television to a news channel. I could understand some newscasters, but could not make out a word that others said. I tuned to a music channel. It sounded awful--more monkeys banging aimlessly on a piano.

That night as I got ready for bed I took off the processor and hearing aid. All sound stopped. No dog tags rustling, no refrigerator humming, no background ambient noise at all. I was felt deafer than I did during the time just after the surgery. I asked Joy to say a few words to me. When I faced her, I could very faintly hear what she was saying. What a relief, I thought. We could still converse, sort of, without being “plugged in.” I might be deaf, but at least (as I had told that clerk) I wasn’t stone-cold deaf. Then the dog barked. I heard that plainly.

Over the next few days things improved marginally. Voices were still loud and somewhat garbled. The television was a mixed bag, with some voices garbled but others more understandable. Music still sounded awful. Most importantly, Joy and I could converse almost normally.

We went back to the audiologist for a checkup. On the word recognition test she gave me I scored 70 percent. She thought this was very good and I was adjusting very well. She tested the implant ear to check for any residual hearing in the low ranges. There was a little bit, enough so that a hearing aid might help. I was doubtful because without the processor on, I heard nothing in that ear. But I was willing to try so I asked her to order one. This would give me a hybrid system as described earlier. She also changed the programming on the processor, giving me a choice of three progressively louder programs. We made an appointment a month later.

Gradual Improvement
Over that time my hearing continued to improve. Voices seemed clearer and easier to understand. I could hear in most meetings and restaurants. I still had trouble using the phone. Ambient noises like paper rustling became less of a problem, but the refrigerator still sounded loud. One cat has a loud purr; the other has a soft, quiet one. And, with the CI on, that dog has a LOUD bark.

There’s not much to report over the next month except to say things got better and better. Joy thought I was doing wonderfully. Conversation seemed fine, even in groups. TV was understandable; I even asked Joy to turn it down once. The phone was still marginal and often I heard better using the hearing aid in my left ear, rather than with the CI in the right. Music was okay.

When I took off the CI, silence enveloped the world. I felt deaf. Sometimes after a busy day the quiet was welcome. I had worried that with that without the hearing aid or the processor I would be totally deaf. But with difficulty I could have a simple conversation with Joy if I faced her and listened carefully. I couldn’t hear the phone ring or the cats purring—but I could still hear the dog bark.

At the next appointment, the audiologist fitted a hearing aid to the processor. The aid was a simple tube connected on one end to the processor, with the other end attached to an earbud in my ear canal. The processor automatically augmented the low frequencies I was missing. I now had a cochlear implant with a hearing aid—a hybrid system—in my right ear, and my old hearing aid in the other. She made a few adjustments in the programming. We made another appointment in six weeks.

At home, I felt like my hearing continued to make improvements. At a meeting I attended, I heard the chairman very clearly, and understood most of the comments and questions from members of the audience. But I found the new hearing aid gave me very little or no help. At home with the TV on, I took the new aid out of my ear and put it back several times to see if I could hear any difference. I did this with several programs, both music and voice. It seemed to make no difference, and, in addition, the new aid often had a loud constant hum. It was something to discuss at our next meeting.

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

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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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Part 4. The Surgery

Posted By Naama Tsach, PhD, Monday, March 26, 2018


The day of the surgery my daughter Amy, her husband David, and I all headed to the hospital. We sat in a large waiting room filled with other patients and family members awaiting surgery. Everybody waited for the phone to ring at the receptionist’s desk, hoping it was their turn. Finally it rang for me. A volunteer led all of us to the operating prep room, wending our way through a maze of passages, floors, and elevators.

At the prep room I changed into the traditional bare-in-the-back hospital gown. I gave my hearing aids to Amy (the right ear for the last time) with my clothes and personal belongings. The anesthesiologist arrived and asked several questions. She marked my right ear as the one to be implanted. She inserted an IV, started a drip, and must have also injected an anesthetic but I never noticed it. That was it—I was out.

I woke up on a gurney in what turned out to be the recovery room surrounded by the operating room crew, all dressed in their green scrubs, white caps, and face masks. Still under the influence of the anesthesia, in my haze and daze I thought they were election officials from the recent Presidential election. To peals of laughter, I told them I had to get up and vote. The doctor appeared and took off his mask, the only complete face among the crew. That woke me up most of the way and I realized I now had a cochlear implant embedded in my cochlea and skull.

The doctor said the operation went fine. I said I was feeling ok with no sign of dizziness or nausea (which often follows ear surgery). My right ear felt numb and like it was stuffed with cotton (it was) but with no pain.

Amy and David came in. I stayed in the recovery room for what seemed to be about an hour. I was given post-op instructions and told that I had an appointment a week later with the doctor. Eventually they decided I had recovered enough and I could go home. I was given some painkillers and nausea pills but never needed either one. With some help from David, I got dressed and was taken in a wheelchair to the exit. We got in the car and drove home.

At home I was greeted by Joy the dog and the cats. I looked at myself in the mirror. My right ear was covered with what looked like a soup bowl filled with cotton held on by a strap of Velcro that encircled my skull. The right side of my head was mostly numb. I could hear nothing in that ear and very little in the left, even with a hearing aid. Everything was muffled and echoed, and tinnitus was a roar in both ears. I was deaf.

I expected to sleep soundly that night. I was wrong. With the “soup bowl” over my ear, I could lie only on my back or left side. The raging tinnitus rumbled all night in both ears like a thunderstorm.

The next day I was washed out and tired. I still could hear very little. Two days post-surgery my family physician carefully removed the Velcro and the soup bowl and cotton packing. I felt like a magician’s assistant as he pulled what seemed like an endless bale of cotton from my ear.

Things slowly improved. The tinnitus gradually subsided to my pre-surgery levels. I still heard nothing in the right ear, and very little in the left. My quest for better hearing had made me deaf, at least temporarily. A week later we went back to the surgeon for a checkup. The audiologist gave me a mini-hearing test to see if there was any residual hearing in the low ranges in the implanted ear. The test was inconclusive because the ear was still somewhat swollen, but she thought there was some residual hearing. The doctor said the incision looked good.

A few days later I took the dog and one of the cats to the veterinarian for a checkup. I explained to the vet that I had surgery for a cochlear implant and could barely hear. He asked if he could look at the incision. I didn’t mind, and for two or three minutes he examined my head and the back of my ear, asking me to turn this way and that as he asked numerous questions about the procedure and probable outcome. I half-expected him to examine my ear with an otoscope.

At this point all I had to do was wait a few more weeks for activation or “hook-up” day when I would get the processor, turn it on for the first time, and—we all hoped--begin to hear more normally again.

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


Tags:  Cochlear Implant Activation  Cochlear Implant Surgery  listening with a cochlear implant 

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Part 3. The Scan

Posted By Naama Tsach, PhD, Monday, January 1, 2018


Several weeks after my evaluation (Part 2), I received an email from the audiologist saying that I was scheduled for a CT scan of the skull followed by an appointment with the doctor. (A CT scan is a special X-ray that produces cross-sectional images of a part of the body.) This meant more waiting, but at least it seemed like good news. It seemed to me that ordering the scan meant that the doctor thought that I was medically fit for the surgery.

I emailed my audiologist asking if I would be scheduled for surgery at that appointment or if there were any more “hoops” that I would need to jump through. She replied that I should expect to receive a date for surgery at the time of the CT scan and that she thought I was finished “hoop jumping.”

As we drove to the clinic for the CT scan, I endured jokes by Joy and my daughter Amy about what the CT scan would find in my skull—no brains, but a big empty space. Of course, the real purpose of the scan was to examine both the cochlea and adjacent mastoid bones and provide guidance for the surgeon to install the implant.

The scan took just a few minutes. Then, at the surgeon’s office, a resident told us that the surgery was scheduled in seven weeks. He explained some of the hospital procedures and the operation. I might have to remain overnight after the surgery, depending on how I felt and reacted. Because cochlear implantation requires anesthesia and may disturb fluids in the inner ear, some patients feel dizzy and nauseous for a while after the procedure. This typically resolves quickly.

We then talked with the surgeon. I had expected him to recommend that I have the left ear implanted because the audiogram showed that I have a greater hearing loss in that ear. To my surprise, he recommended an implant in the right ear. Although my left ear did have a greater loss, the word and sentence recognition tests indicated that my right ear had better clarity (and better sentence understanding) than the left. He recommended that we implant the right ear.

A week after surgery I was to return for a post-op checkup. About a month later would be turn-on day when the audiologist would hook me up and turn on my cochlear implant.

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

Tags:  cochlear implant process  steps to a cochlear implant 

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Cochlear Implants—Pay It Forward*

Posted By Naama Tsach, PhD, Monday, December 18, 2017
Updated: Thursday, December 14, 2017

The following is an excerpt taken from the December 2017 issue of ACI Alliance Calling.

Everyone remembers certain events that were major landmarks in their life: marriage, a new job, birth of a baby, or—not so happy—death of a loved one. For me, after watching my hearing deteriorate for almost half my life (I’m 82), getting a cochlear implant was one of those major landmarks.

With my new CI, I was no longer isolated. I could converse easily with Joy, my wife. I could talk on the phone. Family get-togethers were once more enjoyable instead of being an onerous ritual. I became more active again in the community; to the surprise of some of my acquaintances, I no longer sat there quietly at meetings but talked up and joined in discussions.

When I decided to get a CI, I kept notes about my experiences and feelings. I wasn’t sure what I planned to do with these memoirs. Maybe it could help others with hearing loss considering hearing aids or cochlear implants.

With that in mind, I contacted Donna Sorkin and Naama Tsach of ACI Alliance to see if they were interested in what I wrote. Yes, they were. In fact, they wanted to publish it as part of Naama’s Blog on the organization’s website. They felt that we should use my musings as a way to tell older folks that you’re never too old to get a cochlear implant. (And you aren’t. Just ask me.) 

After some editing by the ACI Alliance staff, my first segment— The Decision—was ready for publication. I am so appreciative for their wonderful job!

Many people have expressed interest in my CI. A doctor I visited had no idea what it was. When I explained how a CI works, he thought the device might help his father who is getting little benefit from hearing aids. My audiologist asked me if I’d mind answering some questions from a patient who is thinking of getting a CI and I have exchanged several emails with the man.

I’ve since met with others who have questions about hearing, hearing loss, hearing aids, and cochlear implants. A friend who is president of the local Lions Club asked me to give a talk to the Club next month. He says he knows several members who might benefit from cochlear implants as they have great difficulty hearing, even with hearing aids.

I also put a note about my CI on my college class website with a link to the ACI Alliance blog, and will have a short article in the next class newsletter.

What else can I do? Well, our local county has an adult education program. Anyone can suggest a class on a topic they want to teach. We’ve had classes on everything from fly-fishing to geology to French literature. Spring term is coming up soon. It’s about time there was a class on hearing, hearing loss, and technology that can help— including cochlear implants!

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

*Editor added the title for Bruce’s article. Pay it forward—a goodwill movement popularized by the movie of the same name starring Kevin Spacey and Helen Hunt. The movie concept was that the recipient of a favor did a favor for others, spreading out good deeds. We think Bruce Sloane is “paying it forward.”

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Part 2. The Evaluation

Posted By Naama Tsach, PhD, Tuesday, November 28, 2017

After years of struggling with progressive hearing loss, the decision has been made and Bruce has set off on his journey. The first step is a meeting at the CI center to determine whether Bruce would be a good candidate for cochlear implantation, collect more information, and meet with the audiologists and the surgeon. Learn more about his evaluation in Part 2 of Bruce’s story.

Part 2. The Evaluation

A few days after I contacted the ENT clinic, they sent a packet of information and forms to fill out and return. This covered my medical history, operations, medications, allergies, family physician, and so forth. I already had much of it assembled so it wasn’t difficult to fill in the blanks.

What took more time was the “essay exam” asking me why I wanted a CI and what I expected, both of which were good questions. My answer was straightforward. My hearing had deteriorated so much that I could barely talk on the phone. Understanding anything in a group was impossible, and even holding a conversation with my wife was difficult. To understand the TV, I turned up the sound so loud it drove everyone else from the room.

Evaluation Process
The materials from the clinic also included a flow chart of the step-by-step Adult Cochlear Implant Candidacy Process. (You can view a similar version on the ACI Alliance website It stressed that this was a team effort. The first step was to contact the CI program and begin the evaluation process. I’d done that! Next was the audiological evaluation followed by a medical evaluation. After that came a CT scan and maybe an MRI. Finally came the team meeting and recommendation. Three outcomes were possible from that meeting: Yes, No, Wait. I did not want to fall into the last two categories.

It was hard to sleep the night before evaluation day. My daughter picked up my wife Joy and me and we headed to the clinic, which is a few miles from the hospital. I checked in and was met by an audiologist.

The first task was a typical hearing test in a soundproof booth. Without hearing aids and wearing headphones on both ears, I was prompted to push a button when I heard a tone. We then did some testing that wasn’t usually part of a hearing exam that I had previously experienced. I put my hearing aids back on and we repeated the tone testing. This was followed by word and sentence recognition tests. With earphones on and at an adequate volume, I repeated back the words and sentences that I thought I heard. I knew this word recognition test was part of my being considered an appropriate CI candidate. I also received a bone conduction test and testing for any middle ear problems. (There weren’t any.)

Test Outcome—I was a candidate!
Testing took about an hour and then the audiologist provided the outcome. “The tests clearly show that you meet both the FDA and Medicare guidelines for a cochlear implant.” I was astounded. I looked at the paperwork. The audiogram was no surprise. I knew I had limited hearing beyond the low frequencies. Later I compared this audiogram with the previous one. Today’s testing showed I had lost 5 to 10 decibels on practically every frequency in just over a year. Testing wearing my hearing aids showed a moderate to severe loss. Despite their steep price, those things in my ears weren’t helping very much.

Word and sentence recognition tests revealed that I recognized just 12 percent of the words on one test and 32 percent on another—with no visual clues. Seeing someone’s face and filling in the blanks was how I was figuring out what people said. Gradually it dawned on me that I was deaf—not deaf as a post, mind you—but deaf enough that I could barely converse in a meaningful manner.

Another audiologist came in, carrying literature and models of cochlear implants from the three CI manufacturers. We looked them over. I was interested but I was still mulling over the test results. I said that I was not ready to decide which company to go with.

We then left to meet with the surgeon and head of the department. He spoke slowly and deliberately, pausing after every word. (“It’s. Important. To. Understand. Not. Just. Hear.”) Four years earlier, I had open heart surgery to replace a defective aortic valve. The surgeon said he wanted an okay from my cardiologist that I was healthy enough to have the surgery.

I wasn’t worried about what the cardiologist would say. My last visit with him had been several months earlier; he had said then that I was in good shape. I had no doubts that he would report that I was healthy enough for cochlear implant surgery. The CI surgeon said he would write my cardiologist a letter and get in touch with me later. That was the end of the visit and evaluation. I had passed a crucial step and was on the way to a cochlear implant. All I had to do now was to wait for the cardiologist’s letter and we could proceed. I hoped it would not be a long wait.

Tags:  cochlear implant evaluation  how to get a cochlear implant 

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Join an Octogenarian’s CI Journey

Posted By Naama Tsach, PhD, Monday, October 9, 2017
Updated: Wednesday, October 4, 2017

Part 1. The Decision

My name is Bruce Sloane. I am an 82-year-old man and live in a small town in Virginia about 80 miles west of Washington, DC. I started wearing hearing aids more than 30 years ago after I went to an ENT because of mild but continual ringing in my ears. The doctor examined me, said there was nothing wrong with my external ears and said that the ringing was called “tinnitus.” He said not much could be done about it and that tinnitus often was accompanied by some loss in hearing. With that, he sent me down the hall to an audiologist who gave me my first hearing test. The test showed mild hearing loss in some higher frequencies—not enough to need hearing aids, but enough so that my hearing should be retested yearly. The retest one year later showed more hearing loss. And the test the next year showed even more. It was time to get hearing aids. 

My Hearing History
I've been wearing bilateral hearing aids for more than 30 years. I have owned about 10 pairs, each one more powerful (and expensive) than the last. As I needed more amplification, I switched to behind-the ear (BTE) aids. I didn’t mind this, as I felt that my poor hearing was nothing to hide; the BTE aids made it more visible and alerted people that I had a hearing problem. At yearly hearing tests, I've watched my hearing slowly deteriorate, decibel by decibel. 

Two years ago, after testing and getting new hearing aids, my audiologist said, "Have you ever considered getting a cochlear implant?" I replied, "I thought you had to be deaf as a post to get a cochlear implant." My audiogram showed severe to profound hearing loss—60 decibels to no hearing at all--in both ears in the middle and upper frequencies, where most speech occurs. In the very low frequencies, there was a mild loss. 

An Attentive Audiologist
She then explained that the standards have changed, and that I probably met both Medicare and Food and Drug Administration (FDA) guidelines for cochlear implant candidates. I thought it was unlikely that I would meet these guidelines. I had new HAs, and I could function OK. Who needs such a contraption, to say nothing of an operation. And cochlear implants were for deaf children and adults who had lost their hearing for one reason or another. I wasn’t deaf—I could still hear, I thought—or could I?

What the audiologist said stuck in my mind. I had trouble understanding my wife’s speech. It often sounded garbled. We both missed the comfortable conversation and easy back and forth talk we once shared. I could rarely understand anyone on the phone and was always asking the caller to talk louder. Even when they did, it just sounded like they were mumbling. In groups I usually understood little, and the comments I made were often "off the wall" and out of context. I belonged to several organizations but usually sat quietly in meetings because I could not understand most of what was said. I stopped driving the ambulance as a volunteer for the local rescue squad because I couldn't understand what was being said on the radio, and often did not understand the EMT’s instructions. 

Could a cochlear implant help? I didn’t know. 

A Chance Supermarket Interaction
A few days after that, my wife and I were waiting in the checkout line at the supermarket. My wife was talking to the woman in line behind us. Somebody said something to me that I didn’t understand and my wife said, “Oh, he’s hard of hearing.” 

The woman she was talking with said, “So am I. In fact, I’m totally deaf and have a cochlear implant.” The woman and I started talking. She lost her hearing suddenly and completely several years ago after taking antibiotics and had a cochlear implant a year after that. She took off the processor behind her ear and showed it to me. I asked her where she had it done and who did it. The doctor and clinic were about an hour’s drive from my house. I wondered why my audiologist didn’t know of this resource. The woman thought her CIs were life savers and her doctor was fantastic. I asked for his name and phone number, which she was delighted to give me—in fact, she had his number memorized. 

The checkout clerk was listening to us and holding up the line of shoppers (who didn’t seem to mind, they were listening, too) joined the conversation, saying that a few minutes ago, a woman came by with young twin boys and both had an implant. I was amazed. I’m surrounded by cochlear implants, I thought.

When I got home I looked up the doctor on the Internet. His credentials were impeccable, and he received high marks from his patients. I went to his website and left a brief note describing my condition and requesting an appointment. A day later I received an email telling me I was scheduled for a CI evaluation in two months. The office wanted a copy of my last hearing evaluation from my current audiologist and they would be sending me some forms and information. 

The next day I visited my audiologist and asked them to send the doctor the requested information. I also told them that the next time someone asks about a cochlear implant, that he was the person to contact.

I was on the way! Two months seemed like a long time to wait. But when I considered I had been wearing hearing aids for 30 years, I figured I could wait a little bit longer.


Tags:  cochlear implant benefits  cochlear implant candidate 

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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.