Fantastic Journey into a World of Sound


Suzanne Robitaille I first told friends in January that I was considering a cochlear implant. At the time, the media was all abuzz with news of the surgical procedure. Talk-show host Rush Limbaugh had just received an implant after a four-month hearing loss, and stories of the near-miraculous restoration of his hearing were everywhere. Limbaugh's case is unusual -- most adults who are considering the surgery have been deaf far longer than the 51-year-old celebrity was.

As I weighed my decision, I tried to ignore the Limbaugh stories and encouraged my family to do likewise. Anecdotal evidence can be inspiring, but also misleading. Each person's experience with cochlear implants is unique, except for one thing -- it takes a lot of patience, and then more patience, to adjust to the new world of hearing.

LONGTIME WISH. Here's a story about my own cochlear implant, which I received on Feb. 21, 2002. It's a tale that really has no beginning or end. I've always fantasized that an operation would someday bring back my hearing, which I lost 23 years ago, at the age of 4, from meningitis.

A cochlear implant has two parts. The first is an internal device that bypasses the section of the inner ear -- the cochlea -- where normally functioning cells convert sound vibrations into electrical impulses to the brain. Most hearing loss occurs either because the cells are missing from birth or have been damaged from a virus or prolonged exposure to loud noises. Doctors put the implant, which is magnetic, under the skin, just above the ear. Tiny electrodes attached to the implant are inserted into the cochlea.

The second part is a small external device, called a behind-the-ear processor (BTE) that works in sync with the implanted device to decipher sound and speech, and present it to the ear. The BTE looks very much like a hearing aid, runs on rechargeable batteries, and is also magnetic. The BTE has been around for only a few years. Previously, users had to wear a processor, attached to a wire, around their waist. The BTE's invention is the main reason why I finally decided to get the cochlear implant.

THE RIGHT STUFF. Doctors and audiologists at the New York University Cochlear Implant Center conducted extensive hearing tests and X-rays to determine if I was a candidate for the cochlear implant -- if I would gain some degree of improvement. Although I'm deaf in both ears, I have benefited somewhat from the use of a hearing aid in one ear, which gave me some general sound but not enough to understand speech or music. I have always relied mostly on lip reading. They all agreed that I would make an excellent candidate.

Still, these specialists shied away from telling me just how well my implant would perform. Their assessment considers many factors, including my age, experience with other assistive technologies such as the hearing aid, the cause of my hearing loss, how long I've been deaf, and even my attitude and determination. It was a risk, a calculated one, but the odds were in my favor, the experts suggested. Something I didn't have to consider was the cost: While the entire expense was about $45,000, my health insurance paid for all of it. Most policies will, I'm told.

Four weeks later, I found myself on an operating table at NYU Hospital. The procedure requires an overnight stay, and aside from the normal risks of any surgery, a cochlear implant also has postoperational risks, as well as side effects.

SURREAL SENSATIONS. The most draining side effects are tinnitus, or the perception of ringing in the ear, and vertigo, which occurs because the part of the ear that controls equilibrium is out of whack. Between the piercing ringing and the vertigo, for the first week of my recovery I sometimes felt like I was being hurled through the air in a giant space pod, listening to an imaginary rendition of Verdi's Falstaff. It was pretty surreal.

Headaches and sinus pressure were other side effects, but these annoyances typically go away after about a week, which they did in my case. So does the temporary alteration in taste, which made even water seem as salty as the ocean.

Once my scar healed (after about three weeks), I was ready for my audiologist to turn on the implant. She programmed the device to give me sound at a comfortable volume. She also taught me how to use the BTE and its adapters for the telephone, Walkman, and television. I put the device on in the morning and take it off at night, when I shower, or when I go to the gym.

DONALD DUCK AND JACKO. I heard sound as soon as the audiologists had finished programming the BTE, but everyone whose voices I heard sounded as if they had just sucked helium. Soon, people sounded more natural, and I stopped visualizing them as Donald Duck.

I've already talked to my family on the telephone, using an adapter. I used to rely on a teletype phone for the deaf, where a telephone operator would type back my mother's spoken words to me on a machine.

The other day, I heard the New York City subway arriving while I was at the top of the stairs and ran to catch it. That was a new experience -- I never had to run for trains before because I didn't hear them coming. And while shopping the other night at a drugstore, I heard music coming from the speakers above -- a Michael Jackson song. I was so happy to hear music -- even if it was Jacko -- I almost did the moonwalk.

STICKING PROBLEM. Already, my boss has mentioned that my enunciation is improving, which is because I can better hear myself talk. When friends ask what they can do to help, I say: "Just talk." This, of course, leads to entire conversations about Britney Spears's love life, but I don't mind. I'm hearing things that I never did before, such as birds, raindrops, or burgers sizzling on a grill. Before the implant, my hearing aid would not have been able to pick up such sounds.

This isn't perfect. A major problem in the beginning was that the BTE fell off a lot. I came close to dropping it in the toilet on the first day. I was assured that as I got used to wearing the device and aligning it with the magnet in the implant, that would cease to be a problem. Happily, that's the case.

Also, while I can hear more general sounds than I used to, I can't quite decipher peoples' speech yet without also reading their lips. This will take practice, and plenty of time. Eventually, I think I will probably be able to do this. It has only been a couple of weeks since my operation.

WHY WAIT? Before the surgery, I went to a meeting in New York City at the League for the Hard of Hearing, and I met a group of wonderful people who have successfully received the implant. The question everyone kept asking me was: "What are you waiting for?" I've been waiting most of my life, and I didn't have an answer for them. Now, I understand the question.

If you're deaf or hard of hearing, ask yourself the same thing. If you're left scratching your head for an answer, then you probably ought to look into a cochlear implant. You might not get front-row seats in the concert of hearing at first, but you'll definitely find a spot on the lawn. The rest will follow. That's where I am now, and I can't wait. Robitaille writes Assistive Technology, only for BusinessWeek Online


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