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Bilateral Cochlear Implants: A Fitting Choice for Mother and Daughter

In many ways, Michelle Tjelmeland and her 10-year-old daughter, Ellie, are hearing miracles. With the help of modern technology, they went from the world of total silence to hearing and rejoicing in he ordinary sounds most of us take for granted. The doorbell, for example, or the timer on the oven, make Michelle freeze with amazement, she says.

Two years ago Michelle and Ellie, of Springfield, Ill. became two of only several thousand people worldwide to receive a cochlear implant in the second ear the procedure called a bilateral or binaural implant. Since then, mother and daughter hear new sounds every day, Michelle reports. We can use the telephone, the cell phone, listen to our iPods, go through a drive-thru everything a normal hearing person can do.

Wired for Sound

The National Institute on Deafness and Other Communication Diseases defines cochlear implants as small electronic devices that can help provide a sense of sound to profoundly deaf or severely hard-of-hearing people. They consist of an external portion placed behind the ear and a second portion that is surgically implanted under the skin. Unlike hearing aids, which amplify sounds, the implant bypasses damaged hair cells in the inner ear and electronically stimulates the auditory nerve, sending signals to the brain, which perceives these impulses as sound. This does not give a person normal hearing, but a representation of sound that helps them understand speech. Also unlike hearing aids, use of a cochlear implant requires a surgical procedure and a rehabilitation therapy to learn or relearn the sense of hearing, although young children, whose language and cognitive skills have not yet developed, adjust much quicker.

According to the Food and Drug Administration which approved the first implant in 1984, and the first childs version in 1990 y 2005, nearly 100,000 people worldwide have had implants. In the United States alone, an estimated 22,000 adults and nearly 15,000 children had received them by that year.

However, patients did not receive implants in the second ear until about 10 years ago. To date, only 3 percent of the 100,000 people worldwide who currently wear implants have received two; Michelle and Ellie are part of that figure.

First Steps Towards Better Hearing

Michelle, 34, started losing her hearing in her teens and, by the time she turned 18, she already had her first set of hearing aids. Oddly, there was no history of hearing loss in her family, nothing at all to predict that Michelle would lose all her hearing during pregnancy, or that her child would be born deaf. Subsequent genetic testing turned out to be inconclusive.

Naturally, Michelle was devastated when Ellie was diagnosed as profoundly deaf. I was an emotional wreck, she relates on the website she launched to document their journey, I was confused, angry, upset, and downright scared. Struggling with a progressive hearing loss myself, I recognized the challenges that awaited Ellie. The biggest challenge was trying to hear, speak, listen and communicate with the 90 percent of the world who could hear.

At first, infant Ellie was fitted with a hearing aid, but that turned out to be problematic for a growing child she needed new ear molds every time she grew into a new pair of shoes. She tried several pairs over the course of 10 months, but when it was determined by her doctors that Ellie was not benefiting from her high-powered aids, she received, at the age of 17 months, a cochlear implant. The procedure was successful and Ellie gradually adjusted to the sounds of the outside world.

Michelles Turn

As elated as she was about her daughters progress, Michelle carried a heavy burden. While Ellies hearing progressed, her own degenerated. By 1999, the year of Ellies implant, Michelle became profoundly deaf. A sense of isolation and depression common feelings among people suffering from severe hearing impairment or deafness took over her usually cheerful and outgoing personality.

Eventually, Michelle followed her daughters example and received a cochlear implant as well. It has truly given me my life back, she relates.

Mother and daughter could have lived happily ever after with their respective cochlear implants, but there is much more to their story.

Two Ears Are Better Than One

Hearing specialists agree that two implants are more effective that just one in understanding speech, especially in environments with many competing sounds. So in 2006, Michelle decided to take the next step toward better hearing: the second implant. As for Ellie, who was eight-years-old at the time, we allowed her to make her own decision, Michelle says. Ellie wanted to do this too, so we were one of the first mom and daughter teams to be implanted bilaterally at the same time.

Having a bilateral implant is not an easy choice. Some critics of this procedure argue that the device permanently damages the cochlea, thus preventing recipients from taking advantage of potentially superior treatments for deafness that might become available in the future.

For Michelle and Ellie, however, there is no looking back. Their successful second implants were placed at Carle Clinic in Urbana, Ill. in July 2006. For me, hearing again was fantastic, Michelle says. Words cannot express how my life has changed since being implanted. I have gained my self-esteem and independence back.

As for Ellie, the honor-roll fourth grader who is still undergoing speech and hearing therapy, you would never know she was born deaf. Her speech is near perfect.

Spreading the Message of Hope

Michelles implants opened the door to many new opportunities. When she became deaf, she was forced to quit her middle-school teaching career, but when she re-discovered her sense of hearing, she went back to school and earned her masters degree.

I could have sat back and let my disability overcome me, but I decided to overcome it, she says.

Besides launching her own award-winning website design company, e-websmart, she also founded the Cochlear Implant Awareness Foundation to provide information and inspiration to others considering this procedure. Starting this foundation was like a therapy to me, Michelle says. I am able to positively impact so many lives and help others realize theres hope.

And there is an added advantage to having not one but two implants, as any busy parent can appreciate. The greatest thing, Michelle says, is when my kids are fighting; I can turn off my implants and enjoy the silence. I literally have the best of two worlds.

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