Project: In My Ear
Hubby checked the weather channel to find that there was a predicted winter advisory at 2 p.m. with winds of up to 50 mph and a big drop in temperatures. Should we cancel the appointments? I had three appointments yesterday as part of my cochlear implant (CI) evaluation.
The temperatures were about 40 degrees with conditions of light fog and mist.
When we got to the medical facility, we went straight to the registration desk to verify insurance information and get directions to the radiology department. I was supposed to get a CAT scan. (On a light note: There was no kitty cat staring at me, giving me a “cat scan”)
Next up: The audiologist (audie). Per my list of providers I was to meet, I was scheduled to see a different audie. I didn’t ask what happened. Maybe the other audie was double-booked or had a day off? Whatever, it was a little unnerving to be talking to a medical professional YOUNGER than me. After growing up seeing doctors here and there, they are all older. Now, it’s reversing.
She asked me if I had any questions. I told her I worked with audies all my life. I didn’t really have any questions, but I was curious about the cochlear implants. She wanted to get on to the audiogram testing and stuff. (I tend to rattle on and on. We still had to do all kinds of testing to even see if I qualified for a CI.) So, Hubby found a really interesting magazine and engrossed himself in that. (Poor Hubby, it was a LOOOOONG afternoon for him.)
I raised my hand at all the high and low sounds I could hear. I got a few things with my left ear (the worse ear), mostly low sounds, but not much. She put the headphones behind my ear to see if I was able to pick up anything that way. I felt vibrations most of the time. I did manage to hear a low sound. Then there were a series of what I call “repeat after me” or "Simon says" tests. The audie read off a list of words and I repeat what I thought she said. There were the usual words I was familiar with, such as “airplane”, “railroad”, ”hot dog”, and “cupcake”. I also had to listen to a recording. A male voice!! Ugh. Any person with hearing loss has difficulties with certain voices, mostly deep male voices. I was warned that I would hear the word “ready” before each word. It went like, ready, coat. ready, calf, and so on. I just had to repeat the word after "ready". Other tests involved sentence repeating with the same male voice and at one point, I had to work with sound effects (noises such as wind blowing, voices in the background, etc.) I didn’t bring my left hearing aid with me. I thought about bringing it with me, but it really didn’t do anything for me. I heard some things, but nothing clear. Bad move. I did need to bring it, but the audie did have a spare for me to use.
With the testing all done, we went back to her office. Hubby was sitting in a chair. He was sooo patient. I felt bad; he must have been soooo bored.
The audie told me the results of my testing. I lost more hearing in both ears since my last audiogram testing. What? In the space of sixteen months, there was another decline!! I was slowly going deaf, even in my good ear. She noted that there was a wee bit of improvement during my testing with both hearing aids. That surprised me, because I didn’t think it helped that much at all, even if it was a small amount.
Compare it to the one I posted here. You can see the difference in the amount of hearing loss. This is surprising because most people with Usher syndrome type 2 have, for the most part, stable hearing-it doesn't really decline that much. Then again, my brother and sister don't seem to lose their hearing at the rate I am. I don't know what it is. Everyone's different, I guess.
Anyway, she said that I was a candidate for a CI. She gave me information about the three different brands of CIs: Advanced Bionics (Harmony), Cochlear Americas (Nucleus Freedom), and Med EL. I never heard of Med EL. It must be fairly new. I was given a comparison sheet on all three brands and warranty information and even insurance information (insuring it under home insurance). I got packets on Med El, Advanced Bionics, and Cochlear America. So far, I know I'd want a behind the ear model because I am used to that. I don't like the idea of a body worn model. Decisions, decisions.
Next up: The ENT (ear, nose and throat doctor or otolaryngologist). He talked about the surgery. I had tons of questions. I did ask how many surgeries did he do and he said he couldn’t count them. There were so many. I asked about which CI brands he worked with most and which seemed to be successful. He pretty much worked with them all.
I asked about infections. There were three infections that they are concerend with the most. One was the infection from the product (internal device), the infection from the incision, and meningitis. (I brough that up.) I must have surprised him about how much I knew about CIs. I've done my homework, plus reading about it from other bloggers who chronicle their journeys. LOL.
While the incidence of meningitis is minimal, they like to have patients get the vaccine two weeks before the surgery. There is also some medicine to take before surgery to up the immunity from other infections from the surgery itself. He said from my CAT scan, the anatomy of my ear is normal. The main reason why the CAT scan is done is to see if there is any abnormalties, especially ossification or extosis. (Another light note: It’s now verified that I do NOT have a high concentration of AIR between my ears!!) Some people who have had meningitis have some ossification in their ears and are more likely to have a recurrent bout with meningitis. I did look, shall we say, “blonde” to say that I thought that once you had meningitis, you didn’t get it again. I guess I was thinking that if there was a vaccine for it, then maybe it was a one time deal. Of course, duh, even the flu vaccine and tetanus vaccine don’t make you immune forever.
We left at around 3:50 p.m. (The appointments took 4 hours!! Poor Hubby.) It was the same-misty with a light fog. Maybe the weather changed? Halfway home, people were driving slower. This is a main freeway with 65 mph limit. We slowed down to 45 mph. It was snowing-the icy, wet kind. It was just weird driving into that. Kind of like a curtain-mist and fog to snow. We ended up extending an extra 10 minutes to our trip home. (Just added this last paragraph to those who may be curious about the winter advisory.)
Those of you with CIs: Bring it on. Please comment and tell me which brand of CI(s) you have and how you like it. I will welcome the feedback I get from you.
Other than that, we have to wait and see if insurance will authorize approval for the CI surgery. After that, I will have another office visit to discuss more details about the surgery. I do have concerns about transportation. I don’t expect Hubby to take time off work all the time or to do so much driving for me. I am still working on the decision whether to have the surgery, too. The big factor here is that my hearing seems to be declining. It would be a matter of time before my good ear would be of no use, either. Then I would be totally deaf. Yikes. Baby steps, baby steps…. breathe, breathe....
Labels: audiologist, CIs
34 Comments:
Hi Shari !!! Exciting appointment!!! Wish you could go to Reno, Nevada to the HLAA Hearing Loss Assoc of America Convention June 12-15, 2008 There you could see a lot of happy faces with cochlear implants. That would give you even more confidence. Of course you are blessed with computers. And, reading about so many of us with F C I. Fabulous Cochlear Implants !!!!!!!!!!! Transportation, yes a challenge. Try to round up two groups of two women. (and back up plans too) Make a fun visit to the big city, while you are in the office. Luckily mapping does not take as long now days. All C I's have greatly improved. HUGS to you!!! Molly CC Usher 2..... right ear N22--4/95 and left ear Freedom 2/06
Hello Shari,
Congratulations on failing your hearing tests and getting qualified for a CI! All of your concerns and questions are normal at this stage.
Re: Meningitis shot. . .my doctor did not require it but I went ahead and got it on my own.
Re: Infection on the incision. . .depends on how the Dr. does it, your health history (if you are diabetic or have some other issue, it might take longer to heal), and how well you take care of it after surgery.
I have the Cochlear Nucleus Freedom and am very happy with my choice. I really didn't have a "choice" because Cochlear is the only brand my doctor implants and I live in a "Cochlear zone." Shopping for a CI is like shopping for a car. . .you have to find what works best for you. Cochlear and Advanced Bionics are very reputable and stand behind their products. MedEl is more common in Europe and I have no idea how great their support is.
The most important relationship you have with your CI is with your audiologist afterwards. Find out where you will get mapped, what kind of training background the audiologist has (if they work with Cochlear Brands or AB Brands), etc.
Like you, I like to do my homework!
P.S. Send some snow to Tennessee! I miss living in Wisconsin!
Oh, and one more thing. . .I thought it would be better to wait until after I lost my hearing to get a CI but that is not always best. My hearing aid audiologist said that it was best to get the CI BEFORE the total hearing loss happens because the nerve is still being stimulated.
Thanks, Molly. I never heard of the Med EL brand till you mentioned it. I thought there were only two brands. Decisions, decision. What color? Insurance might take up to 2 months to authorize the surgery.
Laurie-That's one test I wouldn't have to worry about ruining my GPA!! LOL The ENT or the audie did mention something about the shorter the time span the hearing was lost, the better. I probably had hardly any use out of the bad ear for a good 10-12 years. Until recently, I just didn't wear the aid in the left ear. I just started wearing it today to keep the nerves awake. With private insurance, there's no strict criteria for what qualifies a cochlear implant candidate like with Medicare.
Loved the deaf Pepsi ad that's coming out for the Super Bowl that you posted.
They do the mapping in Milwuakee. It would be a lot easier if they would do it in my hometown, but they don't have the mapping equipment, I guess. Oh, well. Thanks for the feedback.
Wow! Thanks so much for your detailed account regarding your recent visit to Froedtert Hospital in Milwaukee, Shari! (Leslie forwarded your account to me!) I've been wondering how you've been doing! I agree with the others - don't let the transportation issue stop you from improving your life with a cochlear implant. It'll work out.
I have 6 students I work with in the FdL school district that have cochlear implants. Three of them have Advanced Bionics (2 with the Harmony, 1 with an older model) and three of them have implants from Cochlear (all 3 have the Freedom). Judging from their successes, it doesn't seem to matter too much between the two companies. (I don't have any experience with the Med-El.) From an educational audiologist's standpoint, I like how I can do an actual listening check of the kids with Cochlear Freedom CIs. Advanced Bionics still hasn't come up with a way to do a listening check, but you are a reliable adult who wouldn't need that anyway. Another issue is the FM system. You'll still be able to use your FM, as is, with the non-implanted side. And with some additional equipment, you can also use it with your CI side. From my experience with the kids in school, I have less problems with the FM set-up of the Freedom than I do with the Harmony. But Advanced Bionics says they're working on fixing their FM issues. Just a couple things to think about...
One other thing to add...I'm back in school pursuing my doctorate (am I crazy?! Yes!!). :) Anyway, I had a class last spring on cochlear implants. The professor was very knowledgeable about all of the companies and about CIs in general. He was employed with Advanced Bionics, though. He said (and I do believe him) that one large benefit of Advanced Bionics is the 'headroom' that their equipment has. That means there's a LOT of room for improvements to be made within your actual CI. I guess the Cochlear Freedom is starting to get close to capacity with their headroom. It's a little fuzzy to me, but I think it's certainly something to keep in mind.
I know I haven't helped you at all with your decision - giving good and bad of both. :) Sorry. But I want you to know what I know, and I'm sure others will do the same. We all want you to be successful if you pursue implantation!! Again, I'm thrilled that you're at least investigating your options so that you can make an informed decision. We're cheering for you at the clinic!! :) Take care and keep us updated!!
Liz
Hi Liz, maybe you could talk to the clinic about getting the mapping equipment at the clinic in town. (Hint, hint).
Good luck on getting your docorate. If I remember correctly, your credentials were pretty long. :) Still undecided between the two. I was told by someone that Med EL was not popular and yesterday was the first I heard of it before I went to Milwaukee.
That's right. I did bring up to the ENT if there was a receiver for the FM system for a CI. I didn't think I had to get a different FM for that. What a hassle that would be. Forgot to mention that.
What worries me, too, is the fact that my good ear may go bad. Many people have bilateral CIs. So I know it's not new.
Will keep you guys posted.
It all sounds very promising and it's wonderful that you went prepared - having done your "homework."
Yes, baby steps, but you can do it!
Yes. Baby steps and breathing. I'll keep you in my prayers. Thanks for sharing about your day and your progress and your concerns.
Blessings.
Glad you made it to your appt and back OK!
I'm new to all this, so it was interesting to read about. Sorry that your hearing declined. I hope one of the options works out well for you.
Oh, the Demon ride was my favorite too. And Shockwave. I don't know if Demon is still there--haven't been there in many years!
Sounds like a good appointment. I would be quite a bit frightened at the prospect. I hope the right things happen at the right time for you. You are always in my thoughts.
I know you had brought up CIs before, but I did not know that you had decided to move forward. Rebecca has the Cochlear Freedom, it had a couple of problems initially - it kept coming apart & turning off and it's taken us a while to get the FM system working with it. Cochlear's customer service has been oustanding & Rebecca says that she likes it better than her old one. A lot of kids at her school also have the Freedom. Before she had the Nucleus. I'm part of an online discussion group that talks about CIs, if you would like to know more about it just email me. Good luck on your journey, I hope the insurance works out.
Hi
So glad the appointment went well for you. Congratulations on being a canidate. That's wonderful news.
I have the Advanced Bionics CI and I'm very happy with it! The Harmony has brought in music with incredible clarity and I can hear so much better in noise these days. Going out to eat used to be something I dreaded due to the noise; but now I enjoy it so much! I love hearing with my Harmony.
Hey Shari!! I'm SO behind on blog visiting lately :( I HAD to come over here and encourage you, though, in your decision to get a CI....as you know, I really love mine!
I researched all three brands carefully before I decided on AB...and I was lucky enough that Vanderbilt would do any brand I wanted :).
I chose AB because at the time, they were working on the new Harmony processor (I didn't get my Harmony until about nine months after my surgery...I used the Auria first) and I thought it sounded fantastic. I love music passionately and the programming strategies the Harmony uses were created specifically for music lovers. I have NOT been disappointed...even though I still have a ways to go with my new ear, music sounds better than I ever thought it would.
I also loved the styling of the processor...very smooth and streamlined...and the color caps that you can use to change the look of the processor and magnet. The rechargeable batteries are an option that only AB had when I was researching (Cochlear has them now, too). And I LOVE my T-mic...it's an earhook that has a mic built right in. It helps to hold the processor on and it captures the sound where it would naturally go...in the ear canal. As far as I know AB is the only one with the T-Mic so far.
I'll send some more traffic your way, so you can get more thoughts and opinions...OK? :)
I'm so excited for you!!!
The Freedom has a mic lock too.
Beth-I still have more research to do. The debate is just heatin’ up. LOL.
La La-Thanks. I’m sure anyone would have concerns when it comes to a life-changing decision. There’s a lot to think about and a lot to compare. Thanks for the thoughts and prayers.
Kila-I haven’t been to Great America in over 20 years!! I’d be surprised it the Demon was still there. I loved the lights in the tunnel. Cool. :What memories…
About the CI? We’ll just have to wait and see.
Laura-You are in my thoughts, too.:) It’s scary. I think any surgery is scary. Good thing for me that my c-section was unplanned. I would have been going nuts. LOL
Candice-I feel like a doofus. I just thought the Nucleus was the same as the Freedom, just that it was shortened to Freedom. Back to the drawing board…
Anon-That’s music to my ears. I can relate to going out in the jungle. There is too much background noise. I’m glad that you like the results you have with your CI. Thanks for stopping by.
Jennifer-Anon said that it was music-friendly, too. I haven’t done much research as I would have liked the last few days. I am taking two classes right now and it takes up a lot of my time. I am mostly comparing the AB and the CF. I have a good comparison sheet that the audie gave me, though. When I have more time, I’ll be going on to the websites of the CI makers.
Candice-Oooh, the heat is on. LOL. When I finally make a decision, I’m, going to be almost afraid to announce it. ;) Seriously, I’m really appreciating the feedback I’m getting from everyone
Hello Shari. Jennifer sent me your way since you're going through the brand decision making process. Tough isn't it?
I chose the AB Harmony, ultimately because the internal implant is more sophisticated, and was implanted about 2 months ago. I have not been disappointed. My blog goes into more detail.
Good luck!
Hi again Shari,
I got your comment on my blog about insurance and cost. It's surprising, but an HMO usually covers more -- as long as you stay in your medical group. Fortunately my medical group brings a local CI surgeon in under contract for CI surgeries. All I had was a small co-pay.
I almost switched to a PPO plan about 6 months prior to surgery because I thought it would be better. Glad I didn't. I would have been stuck with a significant portion of the bill.
As far as the cost -- I'm in California and surgeries tend to be significantly costlier here. Still, you should definitely check into the costs and coverage issues. Fortunately, the implants cost about the same so you don't have to worry about that when making your choice!
Shari! Congratulations on becoming a candidate! You must be so excited :) I wanted to let you know why I picked Advanced Bionics! I picked AB because they seem much more advanced (no pun intended) with technology then the other companies. I like the design of the processor because it mimicked my hearing aid which is what I have been use to. AB has had problems in the past with recalls and AB themselves issued the recalls and that is important to me. I wanted a company that put its consumers first before profit. That says an awful lot about the integrity a company is built on.
Keep the questions coming Shari, we are all hear for ya! :)
Jeff-I really appreciate your input. There are really so many things to consider. Since I can't change my mind, I will have to see what fits my needs. Hubby said something about how we met our deductible for the year so there shouldn't be too much out-of-pocket payments.
Abbie-Looks like a lot of you are AB users. I will have to look into the features, headroom, and company recalls. The more I know, the more questions there are. Knowledge is power.
Oh! I wanted to point out that the charges that we get on our Explanations of Benefits is usually what the hospital and doctor charge the insurance company. It is the paperwork that comes a couple months later to reflect the actual amount paid. The running total that the hospital and doctor get including all the hardware is around 50-60 grand. My insurance company was charged 123,000 and they just paid 30,000.
Jennifer sent me to your blog.
I went with Cochlear America.
Seems like you're a little bit confused with the types of implants/processors.
For Cochlear America - CA that's the company.
About 8 years ago, Nucleus 24 Implant was used.
About 5 or 4 years ago, Nucleus 24 with contour implant (curly tail) came out
About over a year ago Nucleus Freedom implant came out. This has slightly some differences from Nucleus 24, but not that much.
I picked Cochlear America because my audiologist only does that. I went to her for second opinion after my first audiologist said, "Oh you qualify simply because you can speak." Umm..that's not the only reason. So..my new one, does NOT sugar coat stuff, she tells it like it is.
I honestly do not think there's a huge difference between CA and AB newest processors. I think it all comes down to the training. The more you train your ears, the better things will sound. AB has some pros that CA doesn't have. CA has some pros that AB doesn't have. They both have few cons.
Med-El - All I can say is..look at the processor. Ew. It just doesn't seem "right" for me. Plus, they have a slight higher failure rate than CA and AB.
Also, it all comes down to the surgeon, how knowledgeable the audiologist is, etc. IF you ever feel uncomfortable with the audiologist, and you feel that he/she is not adjusting the sounds well...get another one.
I said surgeon, because he/she is responsible to make sure that the implant is countersunk in your skull correctly (otherwise you will feel a huge bump, and some CI users don't like that too much). Some surgeon spend 1 hour for surgery...not taking the time to make sure the implant is flushed to the skull, or whatever. My surgeon spent 3 1/2 hours. I cannot feel my implant at all, and I still have residual hearing because she slowly put in the cochlear.
OH - Freedom implants have a grounder. That's why there's two "cords" that comes out of the implant. Plus, the "curly" ends, helps to prevent less damage to the cochlea, hence why it's possible to save your residual hearing. AB doesn't have that.
I wish you BEST of luck in everything!!!
hELLO! I don't have CI so I don't have any advice but from what I'm reading it seems like a good thing that you qualified for a CI. I hope you are able to come to a decision that's gonna work out the best for you and your family. good luck. here via michele
Hi Shari
I've been implanted with the Advanced Bionics device since 1994 and I have been extremely happy with the device as well as the company. Advanced Bionics has awesome technology. They are located in California - and I liked the fact that they were here in the USA. I always said If I had problems you can find me in California :) Never needed to act upon it because it's been awesome!!
Getting a CI was the best thing I ever did in my life! I lost my hearing overnight and fought my insurance company for 13 months (back then it was experimental). Being able to hear again has been awesome!!! I have no regrets.
I love the controls on the Advanced Bionics device and I love all the different program strategies that Advanced Bionics offers
Wishing you the best
Kim
I went to bed, then I realized that there's still some things missing. So here's a comparison of things that *I* think, only between AB and CA. I know nothing about Med-El
CA - Has been around for years
AB - A soaring company
CA - Two types of BTE. One Mini-Bte, and full BTE (the difference is size, and Mini-BTE does not accept accessories)
AB - only one size BTE, but slightly more powerful BodyWorn
CA - Has contour electrodes to help reduce trauma for the cochlear.
AB - doesn't
CA - Has 4 different programs
AB - Has 3 different programs
(Technically, it may seem really cool to have 4 programs, but some people don't take advantage of having more than 1 program. It gives you a chance to adjust programs according to environment you're in.
CA - Larger BTE
AB - Smaller BTE
CA - 6 Colors processors. Mini-BTE has 12 changable face plates.
AB - Can give your CI personality by changing coil colors from regular to funky (tie dye, marble, check out their site). CA only has 4.
CA - Can use regular 675 batteries (for EMERGENCIES only. You really need to use Powerful CI batteries for everyday situation. Suppose if you went to your parents' and your CI goes out on you, you can quickly go to the store and get 675s then switch them to Powerful 675s) AND has rechargeable batteries.
AB - only rechargeable
Both has an accessory to plug a charger in your car, so you can charge up a battery while driving, or if you're traveling to someone's house.
AB - Is really good with music
CA - the newest implant, and newest processor (Freedom), seem to work very well with music compared to it's predecessor, 3G. I haven't been activated long enough to really tell you whether it has helped.
Regardless, both processors will have slightly hard time discriminating between the vocals and the instruments because it's all blended in. If you have been listening to music for a very long time, and good auditory memory...that's even better. For a new implantee, that wants to "try" to listen to music, it doesn't do much good.
I cannot comment on accessories because I can't see AB accessories on the web. I think it's safe to assume that there's some thing that AB has that CA doesn't, and things that CA has that AB doesn't. I can't compare prices as well. Most of the time insurance companies will pay for this. My insurance will pay for batteries 100%.
AB - Made in America (if you're a pure patriot!)
CA - has HQ in America, but is based in Australia.
Some audiologists are only trained using one company.
CA - no recalls, there has been 1% failure.
AB - Had a recall due to bad batch of implants. I believe it has been resolved. Because of Meningitis, AB has had cases more than CA that implantees had Meningitis (most are kids though).
Their products are very good, and now all CI must have Meningitis shots regardless.
Hope that helped you either way. One last note - someone I know actually had the two different company CI (AB and CA), and she cannot tell the difference. They both sound the same.
So, honestly, I think it all boils down to whether you want to have funky colors, adding personality to your CI (which AB is good at), and what your audiologist of choice works on.
Sorry for the Loooong comment. LOL! I wish you best of luck!
Good luck to you Shari, whatever you decide.
And quit apologzing to hubby! He has the good fortune of being married to you and I know you would do the same for him in a heartbeat if the situation were reversed.
Abbie-I am sure all CI implantation end up in that ballpark. Thanks.
Cyborg Queen-I really appreciate your feedback. The comparison really helped. I was reading the pamphlets I got and I was impressed with the three battery compartment of the BTE, but yes, it is only for emergencies. AB seems to have upgrade possiblities. I'll have to see what upgrades are possible with CA. I've joined a CI listserv. Hope that helps, too.
Michelle-Thanks. It's a different world here, huh? Decisions are hard, especially ones like this one because it's a lifetime commitment.
-Thanks. CIs help a lot where the hearing aid can't. I get so much distortion. It looks like the CI is so clear. Thanks for your input.
Nichelle-Oops. I was typing my last comment when you typed yours. LOL. Thanks. I really need to make an informed decision here. I think I will need to look at the accessories and try them on and stuff to see how I like them, too.
Sorry Kim. My comment left out your name with just a dash. Thanks again.
Hope you are doing well. Just thinking about you this evening and wanted to let you know.
Thanks for checking in, La La. Still okay here. :) Thanks for thinking of me.
Hey Shari! Just wanted to stop by and see how you are doing. I am having problems with my computer so I am not able to get on much lately but it should be repaired this week.
Good luck on the decision and my prayers are with you!
I am late with advise, sorry. It has been so crazy with me. You received some great advise. I know how overwhelming the "three kits" are. I have AB bilateral implants. I love them. I wanted rechargable batteries and music. I also went with looks. I like the looks of the processor. In the end it is what you want. I hope which ever you chose, you get the best results. Stop by my blog!
Valerie
Thanks, Breazy. Been busy with a big homework project. I'll do my blog rounds when I can.
CI Girl-Thanks for stopping by. Better late than never. :) I appreciate your input. I'm glad your CIs are working great for you. I'll stop by your place when I get a little breather from class homework. This is my last semester!! Whoo-hoo.
How are you doing? Just wondering and thinking about ya!
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