HH/Beck: Hi Mrs. Cerf. It is an honor to speak with you. I would like to ask you about your hearing, your hearing loss, and your cochlear implant. So, if you don't mind, perhaps the place to start is with your hearing history?
Cerf: Certainly. Thank you too - it's wonderful to meet with you. I am 59 years old, and I first noticed my hearing loss in grade school. I had meningitis at the age of 3 years. My parents suspected that I was going to be hearing impaired, and the hearing loss was diagnosed as soon as I left the hospital.
HH/Beck: I can't even imagine how scary that must have been for your parents?
Cerf: Absolutely, I'm sure it was terrifying for them, but they acted quickly, and I was fitted with a body hearing aid which was one of the big hearing aids with a cord. My mother and I attended the John Tracy Clinic in Los Angeles, and that experience helped me with listening and speech therapy.
HH/Beck: Please tell me about your primary and secondary education. Were you in special classes or special schools?
Cerf: No, unfortunately, back then we didn't have specialized education services in my local elementary school in Wichita. I was simply placed in the front row of the classroom and expected to speechread and survive on my own with a bit of help from a nearby student who would occasionally prompt me with page numbers and so forth. Although the teachers were made aware of my deafness, my mother did not want - nor expect them -- to give me any special treatment. If I missed something, too bad -- I simply had to pay close attention.
I didn't fully realize that I was different from my classmates until around the 8th grade. I was starting to act out - naturally from boredom. This instinct was corrected by one apparently exhausted teacher. I gradually learned to assume responsibility for what I heard -- or didn't hear. I graduated high school in 1961 with honors, went to college, majored in art, and graduated from Kansas State in 1965.
HH/Beck: So you were a deaf student, wearing a body-aid, with no special support services -- and yet you were on the honor roll and graduated form from college. That's quite an achievement!
Cerf: This doesn't mean I was ignored at home - I was constantly tutored in speech by my mother. She prepared me to become an active listener. As I later sought to prove myself as a student, I became essentially an autodidact, and sometimes prepared for favorite classes months in advance.
I should mention that in high school I did wear one hearing aid in the temple of my glasses. It wasn't powerful enough, and I switched back to the body-aid after a couple of years. Anyway, after college, I was an illustrator for interior designers, practiced for about ten years, and then retired to raise my family.
HH/Beck: OK, well please tell me why and when did you decide to pursue a cochlear implant?
Cerf: I got my cochlear implant about 6 years ago, in April of 1996. This came about when a lowered dB threshold had left me feeling desperate, After an ear infection, my remaining hearing had dropped from 90 dB to over 100 dB, and the body-aid that I had depended on was no longer going to be made.
I sent an application for a cochlear implant evaluation to The Listening Center at Johns Hopkins. When the Center did not respond, I assumed I was not an implant candidate. I had, after all, gone to the House Clinic in 1975 and at the time had been told they were only taking patients with no residual hearing.
Several TDD calls and faxes -- and some nine months later -- my efforts to get the Clinics's attention still yielded no response. Of course in those days, e-mail was not commonly used by the Hopkins staff. As a last resort, I e-mailed a friend in Israel who knew someone at Hopkins. The next morning, Dr. John Niparko e-mailed me, come in as soon as possible ... profound apologies that we've been unresponsive ... our office has been inundated with queries about the implant. So you see, before e-mail became routine at Hopkins, finding someone to hear me at The Listening Center was a challenge!
A month later Dr. Niparko implanted me with the Advanced Bionics Clarion cochlear implant. Weeks later I was fitted (activated) with a speech processor. My husband and I immediately left for a Napa Valley wine auction. Many call this auction the best party on the planet , but of course I didn't do well in all that noise. It was, nonetheless, an exhilarating experience, and each day since has in some way been great fun!
HH/Beck: So you wore hearing aids for 50 years. Please tell me, what's the biggest difference between the hearing aids you wore and the cochlear implant?
Cerf: My body hearing aid offered only limited discrimination in the low frequency range, so I heard only some vowels. Also with the hearing aid, there was constant acoustic feedback.
With the cochlear implant, I receive clear speech recognition in the high frequency range.. So there is a huge difference in my ability to hear speech.
I should point out that, because I'm hearing only from one ear -- and cannot currently benefit from aided hearing in the other ear, I am not able to function well in a noisy environment unless I use the special auxiliary microphone or an FM device with the speech processor. It goes without saying that someday I hope to have the other ear implanted.
HH/Beck: What was the biggest surprise for you once you started to wear the cochlear implant?
Cerf: Probably from the moment it was activated, I became aware of environmental sounds such as a variety of footsteps. My husband was even more surprised than I when I phoned him from the clinic the day of the activation, and we conversed a little. I heard perhaps less than half of what he said, but the emotional impact was overwhelming. For the first time in our 30 years of marriage, we were finally having a reasonably intelligent conversation on the phone.
I gradually discovered music could be satisfying and was building on that with my previous training on the piano and saxophone.
But the biggest surprise was the usefulness of audiobooks. I've listened to every book on tape that I can -- over 400 to date. They helped to offset the challenge I had of mispronouncing unfamiliar words and also helped me get familiar with people's accents, speaking styles, and moods.
HH/Beck: Regarding the phone, that is a very important issue for many people. And I think the ability to use the telephone is nothing short of critically important for the majority of people, both hearing and hearing impaired. Therefore, I should point out that you and I are literally thousands of miles apart as we conduct this interview over the phone and you are doing very well with the cochlear implant. In fact, you have not asked for any repeats, and I haven't offered any!
Cerf: Thanks, the telephone is usually the easiest form of listening for me. Of course, people sometimes mumble, or a phone connection is bad, but I usually relish phone chats. On rare occasions I may advise someone that I'm repeating what he said to confirm that I'm hearing him.
HH/Beck: Any other thoughts that you want to be sure to mention before I let you go?
Cerf: I'd like to emphasize that almost anyone with a profound hearing loss can learn to improve his hearing and verbal skills. The evidence shows that it takes a village of professionals to produce the excellent results we're seeing in the new population.The payoff in this high-tech age is enormous.
I'm especially impressed with the hearing-impaired graduates of specialized auditory-verbal training who are now functioning comfortably with sophisticated social skills.These teenagers and young adults are also seem less stressed than those of my oral generation.
Because some audiologists, speech pathologists, and teachers have come from a 20th century educational background with its hearing-aid-oral culture, some of their teaching methods are unfortunately still grounded in those earlier practices. Because they've been taught to emphasize visual listening, which fosters weak listening skills. The modern alternative, auditory-verbal communication, involves a more rigorous mentoring and certification so that professionals can work equally well in related fields of audiology, speech pathology, and education rather than in their specific area of original expertise.
One of the principles of auditory-verbal practice is to take full advantage of assistive listening equipment. Now we know that adults are often cosmetically self-conscious about wearing these things and they're also praying for smaller and less visible hearing-aids and speech processors. But cosmetics are not an issue with very young children. What is an issue with those working with very young children is a reluctance to use ALDS because the pros and parents feel the hearing-aids and implant equipment are complicated enough to manage.
If I were a young child today, I would fervently hope that I could have the richest possible listening environment. I crave the opportunity to hear not just easy one-on-one conversations in quiet rooms but everything that you hear --in the midst of all the noise and distractions in our real world. Since many of my hearing-impaired colleagues and I -- and some of these kids -- are hearing with only one ear,they can't enjoy this comprehensive hearing without ALDS. It's the job of the audiologists and dispensing professionals to suggest and seriously encourage their use .
HH/Beck: Mrs. Cerf. You are a delightful person and I am very glad that we were able to spend a little time together.
Cerf: Thank you Dr. Beck, it's been fun for me too and I appreciate the fact that Healthy Hearing and Audiology Online are helping educate so many people about hearing health, a wonderful concept!
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