Lindsay Wagner, eat your heart out.

Yesterday afternoon, Steve and I schlepped down to the suburban wilds of Aurora. We met with a lovely audiologist who answered our endless questions, tested my hearing (result: I can't hear for shit), and informed us that if I want, I can have a Bionic Ear. Otherwise known as a cochlear implant.

CIs have been around for a long time, but I had always thought they were for deaf people, people who couldn't benefit from hearing aids. A few years ago, my audiologist mentioned that doctors had started doing implants for people who do benefit from hearing aids, in appropriate circumstances. I looked through some materials, then set both the paper and the idea aside. I didn't see any real reason to go through surgery, and to have to learn a whole new way of hearing sound, when I was doing pretty well with the status quo.

In November, one of my close friends (hi Dawn!) received an implant. Her surgical recovery seemed to be fast and fairly easy, and she's hearing all kinds of new sounds. Our hearing situations are quite different - she's profoundly deaf and doesn't benefit from aids - but her rapid and exciting progress was enough to reignite my interest in the procedure.

We learned yesterday that CI candidates should have less than 60% speech discrimination success (with a hearing aid) in their "good" ear, which will not be implanted, and less than 50% in the bad ear. My left ear, the good one, put up an impressive 28% success rate, while my right ear posted a big fat zero. Interestingly enough, despite my right ear's utter failure to discern random sentences, I correctly heard 41% of them with both hearing aids on. According to the audiologist, this means that my right auditory nerve is being stimulated, giving me context, balance, and sound. And, apparently, this bodes well for my potential success with a CI.

The technology itself is fascinating (see that Bionic Ear link above). A thin device about the size of a quarter attached to a nickel is implanted inside your head, with little jiggly wire thingies extending down into the ear. The implant contains electrodes and a computer chip, which stimulate the auditory nerve (I think - Steve understands the science and engineering aspect of it much better than I do). Outside, you wear a speech processor (which looks much like my existing behind-the-ear hearing aids) connected by a thin cord to a little magnet. The magnet attaches to the implant on the other (in)side of your head and sends the electrical information to the processor. The processor can hold several different programs (e.g., for different situations with varying levels of background noise), each of which is individually mapped for the user's unique needs.

The post-surgery process of learning to hear with a CI is long and requires a substantial time and energy commitment to ensure success. The brain has to learn to hear a whole new way, and to recognize sounds it may never have processed before. But the audiologist thinks that if I put in the required time and effort, I have a very good chance of hearing much better in my right ear than I do now in the left, or with both aids. That's a pretty exciting prospect!

I would continue to wear the hearing aid in my left ear, and supposedly the brain is flexible enough to integrate the two different types of sound processing (my hearing aids are analog, the CI is essentially digital). Other than having to wear a helmet for helmet-worthy sports and not being able to have an MRI (CAT scan is fine), I would have no activity restrictions as a result of the surgery (no swimming or rock climbing for a week, she said, but I think I can handle that). I would also be able to entertain my friends by attaching kitchen magnets and other small metallic items to the side of my head.

I have to make another appointment for one more round of testing, and to meet with the surgeon. I also have some insurance uncertainties to resolve. Assuming neither of these steps produces an insurmountable obstacle, I think I'm going to go ahead with the surgery this spring.

I'm still in a bit of a daze about this decision. When I initially decided to visit the clinic for evaluation, I was very, very excited and couldn't wait to get things scheduled. As soon as I'd made the appointment, though, I was filled with anxiety, and by last week I was contemplating canceling it. Yesterday, when Steve picked me up at work, I was a huge ball of nerves. In the hospital parking lot, I nearly burst into tears, although I couldn't articulate precisely why I was so upset. Steve took me by the shoulders and reminded me that all I had to do was listen and learn, and that we wouldn't do a thing unless it felt right. I took a deep breath, and in we went.

Within a few minutes after meeting the audiologist, I knew I wanted to proceed (assuming I qualified). She put us both immediately at ease, answered our questions thoroughly, and helped me understand how much potential the CI offers for improved hearing. One of the most important considerations we discussed was my need for better hearing as my vision deteriorates. That, more than anything else, is motivating me to go forward with the surgery.

Comments

[Sarahbanshee]

What with the skiing, and the running, and the climbing, and the kick-ass lawyering, I already had you down as somewhat a bionic woman. If you actually become bionic, that's too wonderful!

Seriously, it sounds like a really hard call and a brave step either way. Steve, he talks much sense with his listening and learning advice, and I'm really glad your audiologist sounds so reassuring and helpful. Just wanted to say go you!

I can relate to your initial mixed feelings. It's hard to mess with the status quo. I'm really excited for you, and I'm rooting for you every step of the way! :)

[Alison]

Hi Mad, please do your research re the medical establishment's take on CIs before you go forward with this.

As with all medicine / drugs etc, the bottom line is the CI industry is a multi billion dollar business, and they are trying to sell you a product. Like all businesses, they focus on the sales / marketing talk.

Cochlear have publically stated that they are out for a 1000% increase in the rate of implantation and want to take the US implant rates to 500,000. They want to increase the value of shares by 20%. They are already high in value.

These figures need aggressive marketing, and they *do* work with the medical profession to achieve this. Where is the mention of people who die from CI operations? (About 50 worldwide, cf medical CI conference, Manchester UK 2002). What about damage to facial nerve in some cases? Am not saying it is going to happen, and to be honest the least of my concerns. What gets me more is the whole must hear thing to fit in.

On a personal note, I nearly had a CI 12 years ago (was assessed twice), and decided not to go for it. I do not hear sound lower than 130dB. 13 years on, I think I'm so lucky not to have done it, and got away with a close shave.

That is just me, and I realise everyone is different. Just urging you to do your homework away from the status quo, and nothing has to be done tmrw.

[robwilks]

Madeline

Don't get me wrong, I am sure that you would not make a decision such as this without checking all your facts and not without much soul-searching, but I would like to ask you, why do you feel that you should have a CI?

Is it because you genuinely do wish to becoming more 'hearing'? Do you wish to 'hear' more than you do now? What benefits would having a CI really bring you? Is being able to 'hear' really the be all and end all?

If you have been, and I quote you, "doing pretty well with the status quo", then why do you feel the need for a CI?

Being Deaf myself, if I could choose between being hearing and Deaf, I would choose being Deaf, because being Deaf makes me who I am.

I guess the point I'm trying to make here is: why go through such a horrible, invasive procedure, for something that you don't really need?