Hearing Health Blog

Hearing Rehab: When Should Someone Consider Getting a Hearing Implant?

March 7, 2023

Facebook Live

With Special Guest Brenda Hunter Hanson

Sondra: Hello, everyone. How are we today? I’m Sondra Rierson, an audiologist and owner of Adaptive Audiology Solutions in Carroll, Iowa, with a location in Denison. This is Hearing Rehab, and every first Thursday of the month at 9:00 AM, we discuss different hearing-related topics. Today’s guest is Brenda Hunter Hansen from Cochlear.

Brenda: Thank you for having me, Sondra.

Sondra: So, Brenda, tell us a bit about yourself and your role at Cochlear.

Brenda: Absolutely. I am the Engagement Manager for the Northern and Central Plains, covering North Dakota, South Dakota, Minnesota, Iowa, and Nebraska. My role involves raising awareness about hearing health, the steps to preserve hearing, and what to do when hearing aids no longer provide enough benefit. We help people find out if they qualify for cochlear implants.

Sondra: Brenda is excellent at explaining the procedure and why it’s a solution to consider when hearing aids aren’t enough. But before we dive into that, let’s talk about what a cochlear implant is. Brenda, would you like to start?

Brenda: Absolutely. Hearing aids amplify sound but do not provide clarity. A cochlear implant, on the other hand, bypasses the damaged hearing nerve and directly stimulates the auditory nerve with sound. This means we start hearing electronically rather than acoustically. It’s a different technology that provides more clarity and crisp sounds, but you need to qualify for it.

Sondra: Often, patients think they can just book their surgery, but the first step is determining if they are a candidate, which involves an evaluation by an audiologist like myself. These evaluations are typically done in centers with ear, nose, and throat physicians who perform the surgeries. Through the Cochlear Provider Network, you can also come to someone like me for the evaluation. If you’re determined to be a candidate, we discuss the next steps. For example, this is the internal implant that goes underneath the skin, and the surgery usually takes about two hours, right Brenda?

Brenda: Yes, about two hours. It’s an outpatient procedure, and most patients do fine with over-the-counter pain meds.

Sondra: When you lose your hearing, you lose sensory cells in the inner ear. For instance, a patient recently had no hearing left in certain high-frequency pitches. I explained to her that we can’t bring back what’s not there. By using a cochlear implant, this electrode goes into the cochlea and allows people to hear electronically. The electrode array has 22 electrodes to stimulate the cochlea, providing stimulation for all frequencies, or pitches.

Brenda: That’s right. It allows the nerve to stimulate the brain to hear those sounds again that they haven’t heard for years. The cochlear implant provides hearing when hearing aids aren’t enough by stimulating the nerve electrically.

Sondra: Now, let’s talk about the processors. There are two choices: the Nucleus 8 and the Kanso 2. Brenda, can you explain the differences?

Brenda: Sure. The Nucleus 8 is the smallest, lightest behind-the-ear processor available. It scans your environment to reduce background noise and focus on speech. The Kanso 2 is an off-the-ear option, very small, rechargeable, and automatically starts when you put it on. It’s more discreet and robust, perfect for people who wear glasses, hats, or ball caps.

Sondra: I have a patient who wears the Kanso 2. She has long hair, and it’s barely visible. Women and some men use a hair clip to keep it sturdy because it’s not set on the ear. Both processors are rechargeable, which is a nice option.

Brenda: Yes, and it’s important to note that the process of getting a cochlear implant is a journey. Initially, hearing through a cochlear implant can be different because you’re hearing electronically. The more auditory therapy you do, the better the outcomes. It’s like learning to write with your non-dominant hand; it takes time but gets easier.

Sondra: Outcomes have significantly improved over the years. Today, we fit people who aren’t nearly as deaf as before. The qualification criteria have relaxed, allowing more people to benefit. Brenda, can you explain how we got to this point?

Brenda: Certainly. Hearing loss leads to various compensatory strategies, like lip reading or positioning yourself to hear better. Untreated hearing loss can lead to isolation, depression, and cognitive decline. Previously, qualifications for cochlear implants were stringent, but now we understand the benefits of early intervention. If you were tested and didn’t qualify before, it’s worth getting re-evaluated.

Sondra: Yes, the outcomes today are much better, and it’s exciting to help people hear again. Brenda, what other concerns do you typically hear from candidates?

Brenda: Many express frustration with communication, feeling isolated, and relying on loved ones to hear. It’s crucial to take care of your hearing health, just like your vision or dental health. The first step is an evaluation to know where your hearing stands. This provides a benchmark for future reference.

Sondra: Exactly. The evaluation process is comprehensive, taking over an hour. If you qualify, we discuss your options, and the surgeon’s office schedules the procedure. After surgery, there’s an activation appointment during which we turn on the processor. This is the patient’s first time hearing through the implant. It’s an emotional experience as patients start identifying sounds through the processor.

Brenda: It’s important to note that the relationship you’ll maintain is with your audiologist, not the surgeon. Post-surgery, we provide continuous support, tweaking the settings to optimize your hearing. Cochlear offers free services throughout this journey, ensuring you’re never alone.

Sondra: Cochlear’s support is amazing, and the cost is covered by insurance. Most patients have minimal out-of-pocket expenses. It’s important to communicate this, as it’s a common concern. Brenda, have you ever encountered reasons why someone wouldn’t want to proceed?

Brenda:

So those are very important considerations—everything you outlined there. If your team does not believe that you should move forward, we will always defer to your team because what we want to do at the end of the day is provide you with better hearing performance. And if that’s not the case, then we don’t want to do it. But again, we will always defer to your audiologist and your surgeon for the next steps.

Sometimes we have some people that don’t move forward because they’re not motivated to do the rehab required. And so again, I mentioned, in order for you to be successful with the cochlear implant, you have to do some homework. There’s some responsibility on your end. It’s not like glasses, where you put them on and see immediately. Hearing with a cochlear implant requires that you work at it. 

If someone is not motivated to do the work, then we don’t encourage moving forward. Hearing rehab includes activities such as reading out loud or practicing with apps and tools we provide. 

I was in Oklahoma City and met a recipient during his six-month mapping appointment. He taught me something new. He loves Tom Petty, his favorite musician, and wanted to hear the music again. On Apple Music and Amazon Music, he selects the view lyrics option. As he listens to the music, he reads the lyrics simultaneously, and he said that helped tremendously.

Another thing we have is a robust volunteer network of people like this gentleman I’m talking about who have gone through the process and have a cochlear implant. Sometimes if someone is apprehensive about moving forward because they’re overwhelmed or fearful, we will connect them with someone who shares a similar lifestyle and can speak to what to expect. They can discuss what worked for them and answer any questions. You don’t have to meet these people in person; you can email or have a virtual meeting.

There are considerations for when to get an implant and when not to, and I think your hearing health professionals know when is the right time to get an implant.

Sondra:

Sometimes someone will come in and need hearing aids, but they don’t really want to admit it. Their family pushes them into it. With hearing aids, once you’re introduced to sound again, hopefully, you’ll accept it. If not, you can return the device. Most people offer that, and in some states, it’s required.

With cochlear implants, there’s no going back. We really want to make sure that the patient is committed. It’s not about trying it out; once you’re committed, you’re in it. We want to ensure that you’re committed to making the most out of the process because the success of your implant is crucial. It’s important that everyone is on the same team with the same motivations. If we aren’t, then it’s not going to work.

I really appreciate you taking this time with me, Brenda. We have to go soon, and I don’t want to take too much more of your time. Is there anything you always wish you could tell patients or something you want everyone to know about cochlear implants? Maybe what patients who have received implants say they wish they had known before they were implanted?

Brenda:

That’s an interesting question. What I hear from every recipient I’ve talked to, because I work with them for 6-7 months, is: “I wish I had done this sooner.” That’s it. I wish I hadn’t waited as long. I wish I had done it sooner. If there’s one takeaway, one action item you can do today, it’s to call and schedule a cochlear implant evaluation so that you know where you are today. Knowledge is power.

Sondra:

Exactly, it’s your choice. It’s just knowing if you are a candidate or not. That’s the biggest thing. If you’re frustrated with your hearing aids and have had a second opinion but are still not getting where you need to be, make an appointment so you can know if a cochlear implant is an option for you. 

Thank you so much, and thanks to everyone watching. Our next hearing rehab session is April 6. We’ll be discussing new hearing aid technology and OTC technology. We’ll go over some reviews. Thank you so much, Brenda Hunter Hansen, for joining me today. Have a great rest of your day and week!

Brenda:

Thank you. Goodbye.

Sondra:

Take care.