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My Cochlear Implant: The Gift

Getting a cochlear implant was one of the more gratifying things Ive done. It means so much to me to have the implant, and not a day goes by when I dont enjoy it. Ive discovered that toaster ovens make noise when theyre done toasting and that theres more than one kind of bird chirping along with the crickets. I always stop and listen to the soda fizz.

Nonetheless, getting a cochlear implant was one of the more challenging things Ive done. My journey included several starts and stops, detours, and obstacles along the way. In three years, Id been through parts of the candidacy process in as many times, and had two surgery dates scheduled.

As a journalism major in college, I wrote my first story about cochlear implants for my student newspaper in 1985, shortly after the technology was approved by the U.S. Food and Drug Administration.

Two sides began to emerge: One friend who had been a local disc jockey got a single-channel implant after losing his hearing overnight; other friends who had grown up with hearing loss said that they were happy being deaf.

More than a decade later, I was surprised at how the technologyand candidacy criteriahad changed. I was equally surprised when I met the candidacy criteria in 1999, but ultimately, decided to wait until ear-level processors became more widely available.

A Deafinite Decision

Another issue was one I couldnt talk about with people who had normal hearing and I just couldnt work through it easily.

I wondered Why did I want this?

I was born with a mild hearing loss in the better ear, which dropped to severe-to-profound over the course of several weeks -- just before entering junior high school. I spent many years coming to terms with being deaf. Although I primarily used spoken language, I believe others saw me as hard of hearing. Along the way, I came to identify myself as a deaf person. I learned basic sign language.

Somehow, I felt that wanting a cochlear implant meant that I felt bad about myself as a deaf person. So what if I had difficulty doing things like ordering a cup of coffee -- I still got by. Why couldnt I just accept deafness as a fact of life? The issue became my nemesis. I pushed it to the back of my mind.

I was frustrated as a deaf person. The communication demands of working and living in a hearing world were vast. I realized the cochlear implant was an available option for me. I wanted the opportunity to hear. I reconciled the two seemingly incongruent conceptsI could be happy with myself as a deaf person, yet I also wanted to hear better, if possible. In other words, for me, a cochlear implant meant exercising and exploring my opportunity for greater success.

Crossing the Rubicon

I didnt think I could muster the courage to put myself through the candidacy process another time. But now my heart was set on a December surgery. Since many of the required evaluations were recent, I wasnt asked to repeat them and that made the process easier. The implant center gave me the date for the surgeryand the date for activation. Seeing the activation dates on paper helped me focus on getting past the surgery and actually having the implant. Maybe this time it would happen.

I knew the stress would intensify. The impending surgery and the decisions that needed to be made loomed large. I wrote down the steps I could take to make the candidacy process easier. This time, I told only a few people that I was going through the candidacy process.

My husband teamed-up with me in researching and selecting the device. Although the final decision was entirely mine, this time I didnt feel alone and overwhelmed making this difficult decision. The only easy decision was the choice of which ear to implant. The implant center was adamant about implanting the worst ear, and in my worst ear, I could only perceive vibrations with a very powerful hearing aid, although I hadnt worn one for many years. I had nothing to lose.

But what would I gain? I thought Cochlear implants worked well for other people. I had little faith that a cochlear implant would provide much beyond what I could hear with a hearing aid in the other ear. I had many doubts.

I tried to set my sights on the future by writing down all of my communication goals for the implant.

Another Beginning

The activation was extremely underwhelming. But I wasnt disappointed. I hoped that I would be able to hear sound, and was gratified when I could. When people spoke, they emitted robotic beeps which reminded me of R2-D2 or C-3PO robots from the Star Wars movie. Music was easier to listen to than speech. With a strong percussion, I could pick out a beat to the music which had metallic pitches. Interestingly, when my child played violin that night, it sounded good.

Because of my long duration of deafness, I was prepared for a protracted acclimitization process to adapt to the sounds provided by the implant. I was taken by surprise at how easy it was.

Within a week, peoples voices took on a human quality. At first, I had no ability to understand speech without speechreading. Unfamiliar sounds--and there were many--were perceived as a high-pitched ring. As I began to identify more sounds, the ringing sounds slowly dissipated. After the third appointment with the audiologist to fine tune my cochlear implant, voices started to sound right and womens voices had a feminine quality.

Time and experimentation with speech processing strategies solved most of my sound quality issues within the first six months. Music through the cochlear implant sounded better than music through the hearing aid.

The Spousal Factor

My husband was my biggest supporter. He made a big deal out of every single accomplishment, which boosted my confidence. Whenever I faced a low point, he encouraged me. At first, my husband avoided calling me on the phone, thinking I would be discouraged, but he was thrilled when I called him two weeks after activation without the relay service! When I commented that boiling water made a popping noise, he suggested we get a breakfast cereal that goes snap, crackle, and pop.

The whole family helped with sound identification, explaining the differences between the sound of crickets and birds. When I realized I could understand the radio, my husband suggested radio stations, and we talked about the different formats and why some stations are easier or more difficult to understand.

The Gift

I felt as though Id been given a gift and didnt know what to make of it.

But then I knew--the gift was a greater connection to people. My favorite moments were those in which my new hearing abilities were part of a shared experience, such as the time my husband and I listened to political commentary on the radioand then got into a spirited debate.

My ability to communicate more easily brought changes for everyone as roles were altered and habits shifted. My husband was accustomed to communicating with restaurant personnel. Now, I wanted to order food myself. Slowly, my husband and kids realized when to back off and let me exercise the independence that the cochlear implant gave me in communicating with others, and when to intercede when I was having difficulty.

My neighbor realized she didnt need to speak as loudly. My husband realized that after years of marriage, he no longer needed to tap my arm to get my attention. My kids welcomed the ability to converse with me more easily -- without repeats!

Roller Coaster Ride

Someone said that a cochlear implant would be the roller coaster ride of your life. I found that to be true. Having a cochlear implant has been a bittersweet experience. While I was elated with what I hear, I felt sad at what I missed. I wished the current technology was available when I was a pre-teen. If I had been implanted shortly after my sudden hearing loss, I believe my results would be even better and my life would have been different.

I always thought my first year with the implant was important and special. As the year came to a close, my speech understanding was excellent and my audiology scores reflected that success. But, the numbers didnt matter to me, they only served as reassurance for what I already knew.

The real success was that I was happy with the implant. Im content as a deaf person, but now I also enjoy the opportunity to be hard of hearing.

A version of this story originally appeared in The ASHA Leader, a publication of the American Speech-Language-Hearing Association, at http://www.asha.org/about/publications/leader-online/archives/2004/f040217b.htm

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