What Can You Reasonably Expect from a Cochlear Implant

by Neil Bauman, Ph.D.

Several people have asked me to address the issue of cochlear implants (CI). Although I don’t have a cochlear implant, I know hundreds and hundreds of people that do have cochlear implants.

My friend Denise Portis is one of them. She also has a way with words. Here is her witty assessment of what a cochlear implant is not, and then what it is. (Used by permission.)

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Many people think a cochlear implant “fixes” your hearing. They may think that now that you have a cochlear implant, you have perfect hearing and are “normal”. I realize that most people talk about how things are different by discussing things “alike” first, followed by how things are “different”. However, since I believe there are many misconceptions about CI’s, I’ll start with what they are not.

What a Cochlear Implant is Not

1.  A cochlear implant does not make you Jamie Sommers. You are not the Bionic Woman (or man) and can hear things 4.2 miles away!

2.  A cochlear implant does not make you a lightning rod. Someone with a cochlear implant is not more likely to be struck by lightning than someone else. Sure, if you are playing outside in a lightning storm on a hill without cover, holding a golf club in your hands, then yes, you might be hit by lightning. But it’s not because you have a cochlear implant in your head!

3.  A cochlear implant does not provide crystal clear hearing so the recipient never has to say “huh?” again.

4.  A cochlear implant’s magnetic coil is not a “plug”. I realized my sister must have thought this when she winced when I took it off to show her. There is not an opening to your brain. It doesn’t “plug in” like a cord in an electrical socket. There are no gruesome wires or frankensteinish types of protruding pieces of metal.

5.  A cochlear implant does not make someone begin to have balance problems—at least not usually—although I have heard it can happen. That is why good surgeons always run a battery of tests which include ways to detect if you already have vertigo problems. I have always been “dizzy” (though never blond) and I almost failed the tests at Johns Hopkins on vertigo. I have a mild version of Meniere’s disease, and looking back, I think it began when I was around 18 years old. I did not begin losing my hearing until I was 25.

I have a history of accidents a mile long. Every emergency room doctor knows me by name. I break bones, fall a great deal, and run into things. I actually have no memory of not being this way. Growing up, I was told I was “clumsy”. My CI didn’t make me dizzy. I was already dizzy. I realize that some people begin having balance problems after receiving a CI, but as I understand it, this is the exception to the rule, and not common for CI recipients.

6. A cochlear implant does not allow you to hear every kind of environmental sound. There are still things I don’t hear at all, or don’t hear well.

What a Cochlear Implant Is

1.  A cochlear implant is a bionic type of device surgically implanted into the cochlea of your inner ear. Some consider it a prosthesis. The recipient is “mapped” frequently in the beginning (sort of like being programmed) and then usually once a year for life after receiving one. Each mapping allows adjustments to enable you to hear things more clearly. At the same time the electrodes are tested and checked.

2.  A cochlear implant can be worn anywhere except in the water. One cannot scuba dive after receiving a CI (due to increased pressure). Some, like my own Nucleus Freedom, are “splash resistant”. I can get caught in a rain-storm without an umbrella, or hop into the shower accidentally without removing it and not destroy it. Certainly, should those things happen, I would promptly put it in my Dry ‘n Store (an electronic drying device), nor would I ever do those things on purpose. I mean I do shower on purpose, but I don’t jump into the shower with my CI on with the intent of destroying it. (In hindsight, I thought I should assure you that I do shower, and do so on purpose!)

One can swim with a CI, but not with the outside components attached. Water tends to ruin them. As long as you are not scuba diving, you can still enjoy swimming, snorkeling, and rain showers. You just “play smart” and take off the external speech processor.

3.  A cochlear implant allows you to hear again—when you have reached the point that you no longer can. “Hearing again” and “hearing perfectly” are two different things. One doesn’t grouch that they aren’t “normal” when they can hear after they could not. I can talk on the phone now (in a quiet room with my own phone), I can hear in church, talk to people face-to-face and in small groups. I do not do well in restaurants, large groups, concerts, etc. without special assistance from infra-red or FM assistive listening devices. Loop systems are my favorite way to hear in these “tough” environments. You walk into the room, switch your CI to t-coil mode, and you “hear” without the background noise.

4.  The magnetic coil of my implant connects to another magnet securely embedded in my skull. The magnets connect very well through my skin. Nothing shows, and I try very hard not to appear “gory”. I’m rather proud of the fact, that I’m probably one of the few people I know who can lean into the refrigerator and “lose” their ears.

The weirdest place I ever lost my CI was at the grocery store in the pickle aisle. I was leaning down to try and find the specific type of pickles my family likes when “whoosh” off my CI flew to stick to the metal lid of a pickle jar. As I was desperately looking for my CI, a lady came by, smiled and said, “Are you pregnant honey? Looking for pickles?”

I was so astonished that I replied, “No! I’m looking for my ear!” Needless to say she shrieked and ran.

5.  A cochlear implant can sometimes mask tinnitus, a common symptom and side effect of a progressive hearing loss. Tinnitus may be a humming or ringing sound in your ears. The CI can mask this “sound” and keep you from hearing it. However, I have also met some people that now have tinnitus (when they remove their CI) whereas they did not have it before.

I’m used to the ringing. When I take my CI off at night, the ringing begins, but it doesn’t bother me, and I go right to sleep. When hearing the ringing sound, I no longer shout, “Hello? Who’s there?”

6.  My experience with my cochlear implant is not like anyone else’s. I still hear new sounds every day. But my experience— what I can hear and what I don’t hear—is as unique as my “map”. No two recipients have exactly the same map or the same experience with their cochlear implants.