Can you tell me about the cochlear implant experience?
December 26, 2016 10:32 AM   Subscribe

I am currently being evaluated as a candidate for a cochlear implant in one ear. I would like to hear from others who have had an implant. I understand that I will have to re-learn how to hear in that ear. I am most interested in what this experience is like, and what I could expect.

I was born with sensorineural hearing loss in both ears that has gotten progressively worse over my lifetime (I am 49), particularly my right ear, which is now almost fully deaf. I wear two behind-the-ear hearing aids, but am finding them less and less effective, as my hearing declines. My hearing loss is mostly in the higher frequencies (where I am profoundly deaf), but the lower frequencies have been slowly diminishing as well. I spent a lot of time in my childhood and teens doing speech therapy, to learn how to pronounce the consonants I can't hear. As an adult I am able to function fairly well in a normal workplace, due to coping strategies learned throughout my life (my audiologists are always surprised that I am able to cope as well as I do.) I do reasonably well with lip cues and my coworkers are accommodating. However, I devote a great deal of energy to listening and being aware of what's going on around me.

I am particularly interested in hearing from adults who have had a cochlear implant (unilateral or bilateral). I understand that the experience for children, particularly if they get the implant(s) before they are verbal, is quite different. I also understand that the experience might be different for someone who experiences a sudden loss of hearing as an adult. My two main questions:

What is the actual experience of hearing with a cochlear implant, and how does it compare to "normal" hearing?

What is the process like following the implantation, what is it like to re-learn how to hear, and how long does that process take as an adult?
posted by amusebuche to Health & Fitness (6 answers total) 6 users marked this as a favorite
Someone I know got a cochlear implant and blogged about it at Electric Hearing. Great blog with a lot of details about adjusting to the implant.
posted by Threeve at 10:40 AM on December 26, 2016

This is a very dated article from Wired (2005), but still very interesting given that it not only discusses the then-limits of the tech, but how it was improved in a matter of years.
posted by Halloween Jack at 11:23 AM on December 26, 2016

I work in a cognitive neuroscience lab, and one of our current research projects is on improving speech perception for cochlear implant users. One thing that you said reminded me of what a cochlear implant user recently said to me-- that one thing that really surprised her was how extraordinarily well-rested and energetic she felt after receiving the implant-- that she hadn't realized how much effort and energy she was expending understanding people until a good portion of that was relieved by the use of the implant. She had been going through life utterly exhausted and had no idea that what she was experiencing wasn't normal.

It's very easy not to notice some sensory capacity slowly fading away because it is both gradual, and so important that people will endlessly adapt to whatever they are experiencing. There are cases of peripheral vision loss (as in glaucoma) where people will gradually lose the ability to see peripherally, and can only see the center of their field of view. They may bump into things ("Oh, I'm just clumsy") or get into fender-benders ("I should have been paying more attention.") One common way that people "discover" this problem is at the movies when they realize that there are two people on screen talking to each other, but they can only see one at a time-- and that is when it "clicks" that something is wrong.

Anyway, for your direct question, I wouldn't be as good as an implant user in answering, but I can give you a few guesses or ideas:

1) The experience of hearing with a cochlear implant is probably hard for me to understand, or convey. But, one thing that normal hearing people can do is to listen to simulations made by auditory researchers. These simulations involve taking a CD-quality segment of speech or music, and processing it in such a way that removes the information that a cochlear implant is physically unable to represent. This is very good for conveying to a hearing person the amount of information available to the implant user for understanding speech, but may not directly replicate the "perception" of using an implant. To a hearing person, speech will sound garbled, but still intelligible -> like this. Now, if a hard-of-hearing person listens to this video, they will experience their hearing deficits on top of the distortion caused by the implant, so it's important to remember that in the actual case of getting an implant, you would have access to the same information that a normal-hearing person would when hearing the video. That is, if you retain lower-frequency hearing, your lower frequencies may be slightly more garbled, but the gain from high frequencies could make all of the difference in understanding speech more naturally. So if you want to evaluate the video, you could try asking a hearing friend to listen to it and tell you what they think, rather than listen to it yourself.

2) The brain is very good at this type of sensory learning, and the process will be much more natural and implicit than speech-therapy. You may find that you are hearing strange sounds, but very quickly and very naturally begin to pair the information you now get from context with these new sounds, and form an association. In implant users speech perception tends to improve for up to two years post implantation, and that is a result of a learning process that is much more like "adaptation" than the explicit learning done in speech therapy.
posted by Maxwell_Smart at 12:38 PM on December 26, 2016 [4 favorites]

You might check out this book; Rebuilt: My Journey Back to the Hearing World.
posted by gregr at 5:39 PM on December 26, 2016

I have two cochlear implants. I got my first when I was 12, and I had a gradual hearing loss before and had hearing aids. So I can speak to the experience before and after hearing.

Overall, cochlear implants are fantastic. I hear way better than I did with hearing aids. Worth it 100%. Since you have used hearing aids, you're a great candidate, better than someone who was deaf and didn't have hearing at all and went for a while without ever stimulating their hearing (so deaf babies are still great candidates).

When you first get turned on, it doesn't sound great. It sounds like robotic beeps or donald duck speaking. You will get frustrated and tired. But it's normal and you are told to expect it. It's very tiring to hear with a new sound, so you would probably only have it on for a few hours at most. They encourage for speediest rehab to use only your cochlear implant, but it's nice to use hearing aid as backup for important situations.

You will take speech therapy and I've found it was a full year before I noticed that I was hearing better than before. I would say it takes at least two months before you understand speech well enough to understand sentences. Honestly, it's been twenty years so I would rely more on a speech therapist. But do the work. That first year is crucial.

Now, I can't tell the difference between my old and new hearing. I definitely hear better, and my speech is clearer.
posted by pando11 at 8:49 PM on December 26, 2016 [2 favorites]

Thank you all. Some great reading, and great answers all. Lots to help me get my head around the idea of a bionic ear.
posted by amusebuche at 8:12 AM on December 28, 2016

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