Home from the hospital with a device implanted in my head and a bandage covering my right ear. As with any wound or incision, the advice was to keep it dry.
I was expecting to have to keep it dry for about four weeks—but more about that in a minute. Four weeks without washing my hair. In any case, we were living through a period of confinement to our homes, excepting trips to stores for absolutely necessary commodities.
I tend to toss and turn while sleeping, so there was no way the clumsy bandage—more of a turban than the elegant cups covering the ear that I see in some photos—would stay in place. No particular difficulties, though.
The light headache I experienced the first day continued for a day or two. It was easily handled by an over-the-counter analgesic.
Finishing the cochlear implant video
I had agreed to participate in a video prepared by the hospital about cochlear implants (see here). The first two parts of my participation—my thoughts in advance of the implant and the surgery itself—were already filmed. The third part—the activation of the implant—remained to be done.
The publication date for the video was already fixed. To meet that date, my device activation would have to be done only two weeks after the surgery, not the more typical four weeks. So long as the surgeon agreed, I had no reason to delay activation.
Hearing is Believing
I had been well prepared regarding what to expect when the implant was activated. I had read about people hearing sounds qualified as “robotic” or “electronic”, whatever that really means.
What the implant was first turned on, I did not indeed hear sounds. These sounds confirmed that the basic mechanism was working, that my cochlea, auditory nerve and brain were still capable of hearing. It was a great leap for my morale. While my otorhinolaryngologist had opined that a cochlear implant would most likely help me, hearing is believing.
The first activation session is not so much about hearing as about the care and feeding of a cochlear implant. The audiologist needed to be sure that I could handle the device correctly: how to turn it on and off; how to replace batteries; how to charge my chargeable batteries; how to put the device on my ear and position the antenna correctly. We went through the contents of the whole device system, including the drying device, the charging device, the connection to the smartphone and how the smartphone app could control the implant.
No Small Miracles
Coincidentally, the French television had just published a video about cochlear implants, featuring the implant activation for an older man. It appears in the video that he was able to understand and converse immediately following device activation.
It appears that a few people have this ability. The cochlear implant, such as it is configured out of the box, just works. For such people, the device is like a hearing aid. You turn it on and you can hear! Well, for most people, turning on the cochlear implant is merely one step in a long process of device adjustment, listening, talking and doing exercises.
When it came to the stapedectomy, I was in that very small class of people for whom the operation made my hearing worse. But when it came to the cochlear implant, I joined the vast majority for whom comprehension would be the result of a long period of rehabilitation. No small miracles for Robert there.
Starting the Rehabilitation
The most important advice of the audiologist was simply to wear the implant and to listen to people talking. Wearing the device might seem self-evident, but I suppose many people find reasons not to do so.
One set of reasons concerns what people hear. Since they do not understand these sounds and since they did not have reasonable expectations regarding the need for rehabilitation, they might be deeply disturbed by the noises they hear. And believe me, you hear all sorts of things you had completely forgotten could make sounds (assuming you had been able to hear something before the implant). And those sounds can indeed be noisy and disturbing.
A second issue concerns the environment in which one lives. I live in a house with my wife. I have worked independently for many years, so I had no office to which I would repair on a daily basis. In fact, my professional activities had been tailing off and I was not dealing with clients on a daily basis. Finally, since was have been living in an era of social distancing, most people have been hesitant to interact on a face-to-face basis. In my case, all these factors resulted in an extremely quiet environment, with only a few hours of hearing human voices each day.
The third issue with wearing the processor of a cochlear implant is that it might be physically uncomfortable. I was accustomed to a hearing aid, so the component behind my ear was not novel. In fact, lacking the tube going into the auditory canal, I was surprised how well the device stayed in place. The other issue is the external antenna. Since it is held in place by magnets, it might be necessary to adjust the strength of the magnet. Too strong and it might irritate the skin or just hurt. Too weak and the device might easily fall off. As it happens, I have not had any issue with the magnets.
Speech Therapy
The hospital has a speech therapist on staff. My insurance entitled me to a series of sessions with her. However, she was fully booked, so I had to wait a few months before a slot opened for me. A will return to my experience with the speech therapist in a later posting.
The Start of Exercises
The early phase of rehabilitation combines sessions with the audiologist to tune the cochlear implant to the patient’s particular needs with the exercises done by the wearer of the implant. I will describe those exercises in my next installment.