How Do I Know If I Need a Cochlear Implant?
Ah, the mysterious yet commonly talked about cochlear implant — what have you heard about it? Chances are, if you’re actually a candidate, you haven’t heard much (no pun intended). I get asked daily, “Allie, isn’t an implant a magical device that can make anyone hear again? Can’t I always keep that in my back pocket if my hearing gets tragically bad?” Well, yes and no.
Cochlear Implants Are Great…
Cochlear implants truly are a miracle for those who need them. Plus, I get to revel in the fact that my voice is one of the first sounds my implant patient will hear — it’s such an honor to share that with them. I’ve seen cochlear implants change lives, restore lives, and pave the way for bright futures.
…For Those Who Need Them
But a cochlear implant meets a very particular need. It’s an invasive, costly, permanent procedure, and there are many obstacles to overcome before getting to the surgical finish line. Fortunately, most people’s hearing needs can be met with appropriate hearing technology.
First, Get a Hearing Test
Start with a hearing evaluation, which is about more than just hearing ability: Is earwax keeping you from hearing well? Maybe an ear infection? (Buying a personal sound amplifier from Walgreens won’t fix those problems….) I also make sure your eardrum and ear canal are in good shape. Finally, the testing also tells me what you can and can’t hear — it’s like a prescription for better hearing.
Second, Try a Hearing Device Fit by a Professional
Remember the phrase “appropriate hearing technology” from above? Our old friend Mr. Amplifier down at the Walgreens isn’t going to cut it. An amplifier amplifies everything equally across the board, and let me tell you, folks, it can get uncomfortable fast. A true amplifier makes everything louder — your voice, your footsteps, your dog’s bark, that midnight snack you’re trying to get away with, everything. In fact, they can do more harm than good.
An audiologist like me, however, can help you determine the best device for your situation. Then, using your hearing test results, I assign the right amount of amplification to only the sound frequencies you need help with. But even more than that, I have the know-how to fine-tune your hearing aids even further for your particular hearing needs.
But what if your test confirms that, for example, you can’t hear thunder? What if you’ve worn hearing devices (real ones!) without great benefit? That’s when we’ll have our cochlear implant chat.
Third, Chat About Cochlear Implants With Your Audiologist
If we decide together that it’s time to consider a cochlear implant, you’ll need to have a special test called the AZ Bio. While wearing hearing devices, you’ll be presented with unpredictable sentences and asked to repeat them to the best of your ability. If the results of the AZ Bio suggest a cochlear implant is worth pursuing, you’ll meet with an ENT doctor to determine surgical candidacy. A psychological evaluation is also recommended. If this entire team thinks you’re a good candidate, you’ll meet with me once more to choose style, color, and accessories.
Fourth, Temper Expectations
After your surgery, you’ll take about a month to fully heal, then I’ll activate your device. Many people have the preconceived idea that they will hear great the second I turn on the implant. I will admit, those activation videos on YouTube of babies hearing for the first time will make you reach for a box of tissues, but those moments seldom happen.
With a traditional hearing aid, you hear acoustically — that is, via sound waves moving through your ear canal and hitting your eardrum. But a cochlear implant, using an electrical signal, bypasses your ear entirely and stimulates your hearing nerve directly. When I turn the implant on, your brain has to relearn how to hear, because it’s hearing electrically, not acoustically.
The best way to describe this comes from a cochlear colleague (looking at you, Jess Goodstein!): Pretend we’ve boarded an international plane, and we have absolutely no idea where we’re going. After 13 hours, surprise! We’ve landed in Japan. Suppose, like me, your knowledge of the Japanese language is deplorable. After deboarding the plane, we would hear people speaking this language, but we wouldn’t understand it. Suppose we had all the money in the world, and we stayed in Japan for a few months. Slowly, we would begin picking up what some of the words meant. If we stayed for a few years, there’s a good chance we’d be fluent in Japanese. Some people are better at picking up languages than others, and that’s the same result I see with implant patients. You have to be dedicated — it’s a marathon, not a sprint.
Fifth, Know You’re Not Alone
I’m here to ground you and set a realistic bar, but I’m also here to hold your hand, be your coach, and celebrate your success. Our profession has an undeserved stigma for being hearing aid salesmen, but I assure you that’s not my goal — it’s to sit down with you and find out how I can help you. If that requires a hearing device, we’ll talk about what’s feasible. If you need more help than a hearing device can provide, I’ll tell you about all of your options.
The undeniable connection between brain health and hearing health is too important to overlook. If you feel like this blog has spoken to you, or if you have questions, please don’t hesitate to schedule an appointment with me. Be optimistic about the next step in your hearing health care journey — you never know, we might be headed to Japan!
Board-Certified Doctor of Audiology