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 

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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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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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.