I lived my life until 2014 feeling I had good (or at least good enough) hearing even as the feedback I started getting from friends and my surroundings proved otherwise. I was self-conscious and resistant to the idea of using assistive devices, feeling that hearing aids were too expensive, complicated, and uncomfortable and would make me look older. But as I was having to constantly ask people to repeat themselves I realized that already made me seem old. I was also starting to withdraw from social group activities and isolating myself and knew that was not a good thing for a happy life.
Then I learned that the Veterans Administration covered hearing aids. I promptly got an appointment with a VA audiologist at the Santa Ana Clinic. She said my hearing loss was moderate in my right ear and slightly worse in my left. I remember the appointment when I got my hearing aids. I was able to hear people speaking all around me. I also began hearing bicycle riders coming up behind me on the bike paths.
Fast forward to December 2021 and I began to notice I was asking my wife to come with me to see the doctor because I found I couldn’t hear words, think of their implications, and remember everything at the same time. I could hear but not understand very well what people said to me. My hearing aids were loud enough but they just weren’t clear.
I found the music very hard to hear. It was beginning to sound more like noise. I couldn’t use my cell phone unless I used my hearing aid Bluetooth function or I put the phone on speaker and my wife carried on the conversation on my behalf. In one-on-one conversations, I relied heavily on reading lips. It was not something I was conscious of doing but as soon as someone looked away, wore a face mask, or it was dark and I couldn’t see their lips, I realized I was doing it.
My wife suggested I get a hearing evaluation by a hearing medical doctor she knew, Dr. William Luxford, at the world-renowned House Ear Clinic in LA. He told me I had severe to profound hearing loss (10% word recognition) in my left ear and moderate hearing loss in my right ear (about 50% word recognition). He was very optimistic I was an excellent candidate for a left ear cochlear implant or CI and said the surgery risk was small. However, he said I did not qualify under Medicare guidelines for a CI because while my left ear qualified my right ear did not, so the CI surgery would cost me $30,000-$50,000. He did suggest I have my hearing evaluated by the VA as they might have a different CI qualification. I was evaluated by the VA in January 2022 and told I did not qualify- similar to the Medicare guidelines but could be re-evaluated in 6 months.
I began to think and learn about cochlear implants.
Cochlear implants use a sound processor that fits behind the ear. The processor captures sound signals and sends them to a receiver implanted under the skin behind the ear. The receiver sends the signals to electrodes implanted in the snail-shaped inner ear (cochlea).
The signals stimulate the auditory nerve, which then directs the signals to the brain. The brain interprets those signals as sounds, though these sounds won't be just like natural hearing.
It takes time and training to learn to interpret the signals received from a cochlear implant.
My mind started to go through a pro and con evaluation process. CI surgery damages part of the ear and there is little or no residual hearing left which means that things like hearing aids will never work on the ear again, nor would I be able to take advantage of future stem cell or other technology that might require an intact ear. Once I had CI surgery I would be deaf in that ear so there is no return if the CI fails. And aesthetically the CI processor is visible above my ear.
Then I began thinking of all the things I was missing. I understood very little conversation in my left ear and would still have a hearing aid in my right or good ear. Hearing loss meant less stimulation for my brain, but also more social isolation which is being linked more and more to cognitive decline. I had stopped going to church, working as a Docent at the Nixon Library, going to group events and even limiting my bicycle riding for safety reasons. My hearing made my conversations with my wife a constant source of frustration. I was withdrawing from activities that I really enjoyed and becoming depressed and unhappy. What did I have to lose?
Dr. Luxford had told me the longer I waited, the more my auditory nerve would deteriorate. The better the nerve, the better I would do with the implant. Plus the CI implant processor worn on the outside is constantly being improved. I talked to several CI recipients and those conversations were very persuasive. They could hear everything I couldn’t and their spouses were also very happy. Visually the processors were about the size of a quarter and looked like a button. I finally convinced myself that overall the hearing improvements a CI offered outweighed the surgery risk and other negatives of a CI. I would be happy to assume the risks because the hearing improvements will be now and at my age time is of the essence.
In May 2022 I got Covid and tested positive for 11 days. Studies are showing that long Covid affects smell and taste but only anecdotal information that it affects hearing. In August the VA retested my hearing and my hearing loss since January was more than enough to qualify me for VA CI surgery. Finally, after waiting for a CI doctor appointment until December, the surgeon gave me a February 2, 2023 CI surgery date.
The VA audiologist asked me to choose from two CI manufacturers- Advanced Bionics and Cochlear Americas. I determined both were good technology but based on conversations with CI recipients I felt more comfortable with Cochlear Americas. They were the oldest and largest company, my stepson had a Cochlear Americas CI as did a relative from my wife’s family who wore a very small processor requiring no earpiece, which I liked. Both were very happy with their CI so I chose Cochlear Americas.
I will talk about the CI surgery and rehab in a future story.
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