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Sequential cochlear implant activation

Posted Sep 17 2011 5:09pm
My second cochlear implant was activated this week. I was calm (and excited)  before activation, but once I walked into my audiologist’s office, I started to bite my lip in nervous anticipation. My expectations were low as I was born deaf, but my hopes were high. My second implant was done on my slightly better ear – my surgeon and audiologist viewed them as being very similar and they said it didn’t matter which ear I implanted first. I had always relied on my right (better) ear; my right ear had been able to detect and recognise loud sounds with the most powerful hearing aids whereas my left ear could barely detect them. Last year, I felt safer ‘giving up’ my left ear, just in case the cochlear implant didn’t work. Now that I have seen with my own eyes (and heard with my own ear!) that it does work, I was chafing at the bit to get going with my second implant.

Comfort levels indicator
The video starts with the set up session, where my audiologist Eilene set the stimulation limits – I heard a series of beeps in four groups of  frequencies, increasing in volume. I had to tell her when I felt the volume was comfortable, before moving onto the next.

The photo shows the comfort level indicator card, showing a range of comfort from ‘OFF’ at the bottom to ‘TOO LOUD’ at the top. I indicated where I thought each beep sounded to me. Ideally, this process sets a comfortable level of sound across the range of frequencies.

The volume is set at a very low level initially, to enable me to get used to sounds, and over the coming weeks this volume will be increased until I reach a volume level on a par with that of a hearing person. When I was happy with all the volume levels, Eilene switched the cochlear implant on.

Switch-on was such a huge shock, it was as if a tidal wave had washed over me, and I was totally disoriented for a few moments until I realised I was actually hearing Eilene speaking to me. Her voice was so incredibly loud that I almost fell out of my chair! Last year, with my first cochlear implant, I had heard nothing except a few beeps, as my brain didn’t know sound. This time, half of my brain has now been trained, and the cross-over of knowledge and exposure has helped the right side of my brain to respond to sounds. Progress is expected to be much quicker with the second implant.

On the video below, captions have to be manually activated. Click on the full screen option to read all subtitles – they don’t fit on the small screen.


I am able to hear voices although they sound like robots on helium. I am not understanding speech yet, just the odd word here and there. This is MUCH better than my first activation when I only heard beeps! I was tested on environmental sounds with software which showed pictures of pairs of sounds, from which I had to match the correct sound playing, and I scored 95%.

Eilene asked me to put the plug in her sink, fill it up with water, unplug, and listen to the water drain away. Last year, I couldn’t hear anything at all. This time, I heard all of it, high pitched, right down to the last bubbles gurgling down the pipe – I turned around and told her ‘It sounds beautiful’. She was absolutely thrilled as she remembers last year so well. I was told to wait until Thursday before increasing the volume, but I increased it after just one hour. I’ve been given a booklet of sounds to listen for and learn to recognise, and have ticked off many of these already.

I went to see my speech therapist Liz, and as expected, this was a very difficult session! I was given pairs of words to listen to, with similar consonants (e.g. pea/bee, pill/bill) – I got a lot of these right. It took me about three months to be able to do this with my first implant – I remember it was such hard, hard work! I was asked to listen to sets of sentences and choose the one she had said, and got all of these right, although I did not really understand the words as the quality of the sound was so unnatural.

I can listen to music that I am familiar with and follow some of the helium-inflated words, although not all the music is there, but I know the quality will only get better. It’s not enjoyable but I can recognise some of the melody.  Last year, it took me three months of daily listening to be able to hear music well enough to enjoy it. So I am already streets ahead with my second implant.

Listening with both cochlear implants on is just …. phenomenal. It blows me away. Voices sound richer, fuller, louder, whole, they sound natural and normal. How do I know what feels normal or natural, having been born deaf? I think my lifelong wearing of two hearing aids, even though they didn’t help much, has primed my brain enough to help with the effect of synergy. I never wore just one hearing aid on its own. I just absolutely hated wearing one hearing aid – I always had to wear two, to give me a sense of balance. Eilene thinks I have already synched the sounds from two ears. With both cochlear implants on, I don’t feel as if I’m wearing two separate hearing devices – I’m just there, in the ‘zone’, hearing, being, LIVING IN THE MOMENT!

I didn’t expect much from today but my second cochlear implant has just literally blown me away. I can’t wait to see what happens next.


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