Bionic Ear 101: Hearing aids and the CI

Me and Suze at the pool in Houston. You can see the CI dangling under my left ear. 

Regular blog readers are familiar with my bionic ear (AKA, cochlear implant). I've had it for almost four years now. I'm sure that lots of people who had never heard of CIs before they met me are learning that there is a difference between a traditional hearing aid (or "listening device") and a CI. But for the record I'd like to list some of them here, so that if you ever do meet me (or someone else) with either one, you'll know what's going on.

First, I wasn't born Deaf. I lost my hearing due to a group of drugs that I took as part of my CF treatment plan, and then, post transplant, to fight a nasty infection I contracted in winter 2006-2007. These were intravenous treatments. I started noticing hearing loss in college, and, as we increased the doses of these meds, the hearing loss also increased. But, at the time, the choice was hear or die. So I chose to not hear so well and still be alive.

I received hearing aids in 2005, post-transplant, but the quality was never very great. I had behind-the-ear models, which allow for the most sound magnification. I had them in both ears.

Hearing aids amplify sound. That's it. In my case, the inner ear cells had been destroyed, so amplifying the sound didn't really help. I still had problems making out certain sounds, hearing in noisy environments, etc. So we began the CI process once it was determined that my hearing loss was profound enough to merit CI usage.

Since I was "post-lingual" (Meaning I knew how to talk and knew what normal speech sounded like) and had only had severe hearing loss for a short amount of time, I wouldn't need therapy post surgery. Some people do.

The most immediate difference between a CI and a hearing aid is that a CI is implanted--part of it is permanent--while a hearing aid is not. A CI is two pieces--the external processor (what you see in the picture) and an internal part. The two parts are attached via magnet (it's hidden under my hair, but you can see it on boys).

(In this pic-the outside part. The girl can hide it under her hair.) 

The interior part is a little tricky to understand:

That is what's in my head. The "tail" part is wound into the cochlea (hence, the name), which, (briefly) is a set of 22 electrodes that transmit sound information to my brain. Essentially, the old ear structure is bypassed, and I am deaf (for all intents and purposes) in my left ear without the CI. This is one reason I was resistant to getting the implant--I didn't want to lose whatever real residual hearing I had left, because no matter how great the CI, it's never as good as natural hearing. 

So, that's what the implant looks like, and that's how it works. You can see the difference between a traditional hearing aid and a CI in quality--one just amplifies sound, the other helps you understand it. It also has several different channels for music, loud situations, etc. I can plug my iPod into it (There's a special adapter cord. It sort of rocks my world.). 

A CI is great--but it's only as great as you make it. You have to train yourself to set the sensitivity (how much the mic picks up incidentially) and the program that's best for you. When I first got it, I went back to my audiologist at different intervals to have the electrode settings adjusted. Now I have a program that is usually used for music, but I use it all the time, because I get a richer sound.  You will do better if you experiment with programs and tell your audiologist what you are hearing, and what you'd LIKE to be hearing. And the younger you are, and the more "verbal" you were before, the better. I was a musician before--I'm a musician after. My ears were SO important to me. And now, I work hard at bringing myself up to "normal" standards. I've found the CI pitches me sharp, which is very rare in the vocal world--most people are flat, if they're having pitch problems. I have to listen even more carefully than the average singer. Instrumental music I've never heard before is very difficult for me--it just sounds like noise at first. Vocal music isn't so hard, but I have a hard time discerning words if I don't have liner notes to work with as well. (So people--give me liner notes!) 

CIs are also somewhat better on the phone, because the CI mic is directed at the phone. I have a special program (called telecoil) that I use when I'm on the phone. I have to push a button to activate it, so that's why it takes me slightly longer to pick up! My cell phone is compatible with both hearing aids AND CIs--not all are. The same is true for landlines. My phone at work has a special component that helps with the sound quality. 

I do not have bilaterial CIs.  My right ear has about 20% natural hearing, and I'm glad it does, so that when my CI battery goes dead, or it's out when I'm in the pool, shower, or sleeping, I can still hear things, and discern some voices. I can sleep with the CI in, but you DO need to charge the battery every so often! They are good for about 18 hours at a go. I have two. There is a fifteen minute warning "beep" that tells you to change the battery before it goes dead. 

So this is probably more than you ever wanted to know about hearing aids and CIs, but I think it's an important thing to cover. CIs are becoming more common, and people need to know how they work. 

I DO know ASL, but that was a complete fluke--I added it as an elective in high school for two years. I'm fairly good at signing, and will use it when I have to. My little sister also took an ASL course, and my ENT knows some sign. So also take ASL courses, if you can! It's so useful. 

If you have any additional questions, post them in the com box and I'll answer them (If I can).