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(Tammy Gets an Implant Serial)

The Trip

Tammy lives in Maine, and had to drive to Boston, Massachusetts for the cochlear implant evaluation. Leaving Chelsea, Maine at 5:15 am she and her husband arrived in Boston's Tufts-New England Medical Center by 9 am. Why Boston? It is not possible to have cochlear implant surgery done in Maine (yet). The trip out of state had to be authorized by her insurance company.

To her surprise, one of the women she knew who had an implant, was there also to have some mapping work done by Gabrielle Simone, a Tufts audiologist. Her mother, also deaf and an implant candidate, accompanied her.(Tammy later was able to watch this mapping).

The Appointment

Her appointment was scheduled for 9:30 am with Robert Buchanan, a senior audiologist in the Audiology department. Prior to the appointment, Buchanan and Simone had already answered many of Tammy's questions. To prepare for the appointment, Tammy had sent her audiograms earlier along with a form describing her medical history, and brought to the appointment those not yet sent, including ENT medical records, past audiograms, and past surgery information.

The original plan was to do the hearing tests first, but that plan was shelved when something came up. So instead Tammy met with Dr Wiero Shao of the Head and Neck Surgery department. Shao examined Tammy's ears, had her give the medical records she had brought to Buchanan, and determined the better candidate for implantation was the right ear. He also said it was fine to implant the left ear instead, or even to do both ears. As part of the process, he also asked about any health issues.

The Hearing Test

The visit with Shao over, it was back to Buchanan for the hearing test. According to Tammy, "The first test performed was a usual audiogram test with a variety of beeps. I would press a button if I heard a beep and if I felt a vibration I would tell him 'vibration'. I had taken this same test two weeks before with my regular ENT prior to insurance authorization and the results of the test came out pretty much the same as before. No significant change."

The next part of the hearing test was a traditional word test with a hearing aid worn to see how much benefit Tammy received from a hearing aid. This was the "ice cream, cowboy, hot dog" part of a hearing test that many About readers will have fond (and not so fond) memories of. She was told some of the words in advance of the test, and was able to understand those better than words she was not told in advance. Buchanan said the words, both covering and not covering his mouth with a piece of white paper.

Next came a CD recording. Tammy was tested to see how many words in a sentence she could understand with her hearing aid. There was also listening to short sentences. She said some of the CD's voices sounded like a mouse squeaking while others sounded like a boom truck.

Following that was the "noise or voice" test, where Tammy listened to sound coming through loudspeakers and said if she heard a noise or a voice. Then there was a bone conduction test, with an uncomfortable headset, for listening to beeps and feeling vibrations.

The final test was similar to an ear pressure test, with a plug in Tammy's ear and a laptop device printing out the results.

How Tammy Felt About the Hearing Tests

Tammy feels she did poorly on the hearing tests, which she found frustrating. Even so, Tammy was "able to get one whole sentence and some small words like IT, THE from the other sentences. The one whole sentence I got was so simple it just consisted of two words 'LOOK OUT'. Almost everything sounded like noise but hardly anything made any sense."

Watching a Mapping

Tammy was scheduled to meet with Dorothy Eisenhower, a speech language pathologist next, but first Buchanan consulted with Eisenhower about Tammy. Before Tammy met with Eisenhower, she was invited to watch her friend get her implant mapped. Due to her software engineering background, Tammy found this interesting and observed that different software was used for different implants, and saw that her friend had no pain or frustration.

Group Discussion

Buchanan, Eisenhower, and Tammy and her husband sat together to discuss the test results and available implants, and to offer their professional opinions. Buchanan said that with a hearing aid, Tammy had about 30% discrimination ability. After the implant, she would be retested so that the new score could be compared with her pre-implant score. With a cochlear implant, Tammy's hearing would improve to the point where it would be about the same as it was when she was a child with only a mild hearing loss (approx 15-30 db). The likelihood was of a 20-40 db range after surgery.

The fact she had used a hearing aid on the right ear for 12 to 15 years made the right ear the better option. It, and the right side of the brain, would be more accustomed to processing sound.