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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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 https://www.acialliance.org/page/CICareProcess) 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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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.