To Hear or Not to Hear

How I Went from Hearing Aids to a Cochlear Implant by Geoff Fierce

Beginnings

Hearing loss can affect each one of us to varying degrees as we get older, or are stricken with an accident or illness that can take our hearing overnight. I have been a hard of hearing man for a good portion of my adult life, but this loss crept up on my over a fairly long period of time. I first noticed my hearing loss in the late 80’s but didn’t start wearing hearing aids until after 2001. I have always been one to embrace technology and so along with my first set of hearing aids, I also began using an FM System, which helped to direct sounds to me in noisy environments and to shut out much of the outside noise that stopped me from hearing others in these situations. I also used the FM System to link directly from my hearing aids to my Cell Phone via Bluetooth technology, which is a short distance radio-wave frequency that transmits wirelessly from one device to another

As my hearing got worse, I began to look into how a Cochlear Implant (CI) could help me out as I was at the point where I had profound hearing loss in both ears with a very little hearing remaining in my right ear. I went for some initial testing at Central Speech and Hearing in Winnipeg in 2010, but was not quite at the stage where I would benefit from a CI. This changed over the next couple of years and in 2012 I went for re-testing where it was found that a CI would be the only way to restore some of my hearing in the better ear.

So just what is a Cochlear Implant and how does it work?  A CI is an electronic device that partially restores hearing in people who have severe hearing loss due to damage of the inner ear and who cannot benefit from hearing aids. A processor behind the ear captures and processes sound signals, which are transmitted to a receiver implanted behind the ear. Hearing aids amplify sounds so they may be detected by damaged ears. Cochlear Implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound.

After my testing with the Audiologist at Central Speech and Hearing, an appointment was made where I would meet with Dr Leitao, one of the surgeons from the HSC who is involved in this procedure. My wife and I met with Dr Leitao at Central Speech and Hearing in late Spring of 2013 and discussed how I could benefit from having a CI and what the pluses and minuses were regarding this surgical procedure. The earliest that this could happen was after March of 2015. I told Dr Leitao that I wanted to go through with the procedure and looked forward to meeting him once again. After our meeting with Dr Leitao I was to undergo a number of tests at the Health Sciences Centre in Winnipeg and then make another appointment to see him. At our second appointment in early 2014, Dr Leitao told me that I had done well on the tests and was definitely a candidate for a CI, and that there was a good chance that the surgery could happen this year as there were fewer children who were in the queue for surgery right now. I went home feeling good about this and waited once again to hear from the hospital about a surgery date.

While I was away in Winnipeg in June my wife Marlene got a call from the HSC that I was to have my CI Surgery at 11:00 a.m. on July 23rd, less than a month away. If there were no hick-ups with the surgery and I responded well to everything, after the 4 hour surgery and some time in recovery, I would go home the same day. I was both excited and reserved. I felt excited to finally be able to undergo this surgery, yet at the same time a little apprehensive about all the things that might go wrong. These apprehensions were totally unfounded, but the human mind likes to play games with us and get us worrying over nothing.

Surgery

On July 22, 2014, Marlene and I, along with Nestle (my Hearing Ear Dog) headed into Winnipeg and stayed overnight at the home of a close friend. I had to be at the hospital by 9:00 a.m. and the surgery scheduled for 11:00 a.m. I don’t remember a lot prior to the surgery, I guess because I was so nervous and excited to have this finally happen. But I do remember that when they had me change into a gown and booties to cover my feet, that I was totally frozen. It’s funny what we remember before a stressful event and in this case it was how cold I became in the hospital while waiting to go into surgery. Even the warm sheets and blankets they covered me with didn’t help all that much.

When I got home from the hospital I wrote a note to everyone on my mailing list and all my friends on Facebook to let them know I was okay. Here is what I wrote at this time on July 24, 2014:

“I am home from the hospital in Winnipeg, and my Cochlear Implant surgery went well. Other than being a tad sore and tired, I am doing okay. Marlene counted 22 staples that start at the top of my ear, going from above and behind my ear down to the top of my ear and then in an arc behind my ear and ending up stopping at the bottom behind my ear. When I met Dr Hochman, who ended up doing the surgery, he told me that my brain is situated lower than normal in the cranial cavity in my head, and when Marlene spoke to him on the phone afterwards while she was with me back in Day Surgery (where I spent the night), he told her that my Cochlea was situated deeper into my ear than normal and that my facial nerve was closer to the path of the CI Array of Electrodes. Marlene told me that this is because I have a thick skull.

“Everything went well, but this was not a normal CI Surgery even though it was completed within the 4 1/2 hours slated for it. Staying overnight was necessary because there was a larger incision than normal and the surgeon wanted to ensure that everything was okay. I had a bit of a rough night, getting only a few hours of broken sleep, with a lot of pain at the bottom of my ear where the bandage was secured. At the time I didn’t know how many staples there were or where their path was and just thought that there was extra packing behind my ear. I was well looked after by the nurses and healthcare aids in the Day Surgery Department and in this case, nurse-care aced wife-care.  Because my bed was in Day Surgery and they had to have the space available for the next batch of patients I was discharged at 5:30am. From there Marlene and I went for breakfast and then back to the hotel where we packed up and headed home.

“I had to make a couple of stops in Brandon before coming home. The first one was at Walmart to see if the Eyeglass area where I bought my glasses could accommodate my need to have a short arm temporarily replacing the one I have, which wraps around my ear. As the staples had to left open to the air the regular arm would rub on them, causing more discomfort and possible damage. The manager of the Eyeglass Department found a Childs glasses arm and cut it to measure and put it on my glasses as I waited. This works great for me, but still rests on one staple, which is very close to the top of my ear. Once I have totally healed, I will have the other arm put back on. And the best part is that they didn’t charge me a thing to do this.  The second stop was at Keystone Hearing Centre to have my very brittle tube for my left ear hearing aid replaced. Then it was off to Souris to change into something comfortable, start up the computer and let everyone know how I’m doing. I also crushed some ice to help ease the inflammation from where the trachea tube was inserted during surgery and am now all set for the evening. I think dinner will be Mac and Cheese… something soft and not spicy at all.”

So this is how Marlene and I spent our 10th anniversary and I have to say that I hope the outcome will become a gift that benefits both of us and makes for better communication with regaining more of my hearing through my new Robotic Ear.

Activation and Beyond

After the surgery I had a little bit of discomfort which is perhaps normal, but is also something that is different with each individual undergoing any kind of surgery. How we deal with pain and the recovery process is not something that is the same with any two individuals and I think that many of you will have your own experiences to draw upon with how you dealt with post surgery of any kind. I don’t intend to dwell on this, nor do I intend on going into any detail about my own recovery other than to say I survived and am now doing well. If you asked me if I would do this all over again should the opportunity arise for the left ear, my answer would be “In a Heartbeat.”

On August 28, 2014, I headed into Winnipeg to see the surgeon and get a clean bill of health so that I could then move along to the next stage of having my CI activated and start mapping the processors and the signals to my brain, while I learn to hear again. Dr Hochman told me I was doing well, but suggested I take the right arm off of my glasses completely for about a month, to give the still tender area around the incision a chance to heal properly, as I had some redness in this area. I returned to Souris and had Marlene take the arm off, as I can’t see well enough without my glasses to do so myself.

Prior to seeing the surgeon for my follow-up appointment I had been in touch with Central Speech and Hearing to select my Processors and Accessories, and make an appointment for my activation and first two mapping sessions. Yes, you heard correctly; I am to receive not one, but two external processors. The first one is for the Naida CI Q70, which sits behind my ear the same as a hearing aid would and has a short cable attached to the headpiece that is attached magnetically to the internal magnet and processor. The second processor is called the Neptune and very apropos this name is as it is the only CI in the world where you can go underwater with it on.

I headed into Winnipeg again on September 2, 2014 for my CI activation and had my first mapping session the next day on September 3, 2014. I am now back home doing lots of practicing at listening to various sounds, but especially to human speech, with just my CI in place. I try not to use my hearing aid in my left ear unless I am in a situation where it is important to hear what is being said to me. While watching TV I still use Closed Captioning and wear my hearing aid after I become tired and can no longer make out what is being said.

For now, everyone sounds very much like Chip & Dale or Alvin and the Chipmunks, all depending on which ones you are familiar with. Either way you will sound like a Cartoon Character Chipmunk to me right now. This will change as time passes and my brain begins to figure out what all these robotic sounds are, at which time words will begin to sound as they did when I could still hear properly.

A couple of other sounds that have been interesting to try and make sense out of are any kind of music, whether it is someone singing solo, in a choir or with a band, it is all very hard to figure out right now. Musical instruments are a real challenge for me, individually or part of a band/orchestra, and I even found trying to play my Blues Harp difficult to understand right now. But I was told that any musical sounds will be one of the hardest things to figure out and likely take the longest before I can truly hear them.

I had a pleasant experience this afternoon listening to various bird sounds. I have not heard a bird chirp in the wild for well over 10 years and today for the first time in ages I actually heard and understood what the different sounds were and look forward to going out and experiencing these while out photographing birds in my area. Unfortunately most song birds migrate south at this time of year, so most bird sounds will have to wait until next spring. By then almost everything should sound very normal to me and I’ll be able to figure out where the birds are not just by sight anymore, but also by hearing where their songs are coming from.

I returned to Winnipeg September 11, 2014, for more mapping and adjustments and then about a month after that. The appointments will taper off after the next two, down to 3 months, 6 months, 9 months and then annually after that.

I am so excited to slowly start learning to hear again and looking forward to many more new experiences and unique sounds that I’ve lost over the years. Although I know that my hearing will never again be perfect, there is a chance that I will achieve 90% of normal hearing, which is better than many people my age and younger have due to normal wear on the human ear.

I hope to share more of my story with you as time progresses and my hearing begins to improve in my implanted ear and I can once again regain some of my confidence and the feeling of being “Included” that comes with being able to hear what others are talking about. I leave you with one piece of information that I’ve learned through all of this and that is to never give up hope for what your future may be and as technology advances at a rapid pace today, there is a chance for each of you to gain the freedom and joy that restored hearing can bring.