CI: 4 days out - Why CI?

Why am I getting a cochlear implant? My hearing has degraded to the point where I have great difficulty understanding speech, even in quiet surroundings, even with hearing aids. How it got to this point has been a long, slow slide. I’m going to take a shot at describing it. I hope it doesn’t come out too boring.

Hearing loss takes many shapes. Some are born with poor hearing. Others have a sudden loss, which can strike at any age. In my case it has been a mostly gradual loss that became noticeable in my early twenties. Probably the earliest indication that I was different was in my late teens when my ears would ring for days after going to a loud concert. One time I asked a friend a couple of days after a show if his ears were ringing and he said, “no, the ringing was gone by the next morning.” I thought nothing of it at the time.

A few years later, about age 23, after being in bands for a couple of years, I first noticed an actual loss in my left ear. I had a camera with an electronic flash attachment that emitted a tone that rose in frequency as the charge recycled. If I held it to my left ear, at a particular point I could no longer hear it, but could still hear it if I switched to my right ear. Even so, it was a mild loss and had no impact on conversing or playing music.

But the loss progressed. I had always used my left ear with the telephone. When I was 25 I noticed I was struggling to understand people on the phone, so I had to start using my right ear. About that time I had my first appointment with an audiologist. He told me I had the hearing of a sixty year old and should look into hearing aids -- not what a musician wants to hear. Soon after, I traveled to LA for a second opinion from the House Ear Clinic, a well known center for hearing research. Of course the audiogram was the same, but I got a better explanation of the problem: it wasn’t likely related to noise exposure, so no need to give up music at that time. That was a relief, and since I wasn’t really struggling with speech I felt no need to get hearing aids. That changed in a couple of years. By age 27, I was straining to understand soft-spoken individuals, and just about anybody situated on my left side. Within a year, at age 28, I was fitted with my first pair of hearing aids. For a person used to enjoying the nuances of sound it was quite awful. The hearing aids of the time (circa 1988) were linear amplifiers, meaning, whatever sound level entered the mic was boosted the same amount. They definitely helped me in quiet environs, but produced a distorted cacophony in any kind of sound-rich setting, like a busy street. So they spent quite a bit of time in my pocket instead of my ears.

Over the course of the next few years, even as my hearing worsened, I could still hold good conversations without hearing aids in noisy locations, and with hearing aids in normal to quiet situations. And music still sounded good. But certain circumstances were becoming difficult, such as hearing well in a widely spaced group either outdoors or in a noisy location indoors. In 1992, I upgraded to a new set of hearing aids that featured dynamic range compression. They were a huge improvement. I no longer needed to swap the aids in and out, and they performed better in all situations. It was like turning back the clock.

For about the next ten years, I continued to hear adequately with hearing aids. I could use the telephone and handle most conversations. However, I did give up performing music, partly because it no longer sounded “right.” I was also noticing that hearing was becoming more of a mental strain – it just took more work.

The summer of 2002 is when I had my “big drop.” I was returning from a week’s vacation in Northern California when my right ear started roaring, a loud continuous chord of tones. That tinnitus gradually dissipated, but gone with it was a chunk of hearing in my good ear. I had depended on my right ear, since my left was significantly worse. Phone calls and conversation went from a strain to a true struggle of attempting to fill-in missed words using context and guesswork.

For a couple of years I tried to squeeze as much performance as possible out of hearing aids, trying several new models and brands. But by 2006 it had become clear I had reached the limit of hearing aids. Louder wasn’t better. Speech was becoming even more indistinct. Music sounded mushy.

I had been following the progress of cochlear implants for quite some time. In my early investigations they didn’t seem like much of a solution for someone like me who could still hear, just had trouble discriminating. And I was bothered with the news that the good ear of the two was usually implanted, and by the fact that the surgery destroys any possibility of normal hearing. But looking into it again in 2006 I found out that the worse ear is implanted first, and that recipients were seeing big improvements in speech discrimination. I had hoped that some sort of magic bullet gene therapy solution would happen, but it looks like that’s not in our near future. CIs are here and now, and the improvements to them technologically in the past few years are astounding. So I began working my way through the HMO process of referrals, and after 18 months of starts and restarts, here I am – four days from surgery!

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