2nd Cochlear Implant: Post-Activation Day 43

Background

The last time I wrote, it was prior to getting the surgery for my second cochlear implant. I was slightly nervous about the pain of the surgery, but eagerly anticipating activation day. Well, that day has come and passed, and my brain has had almost two months of learning how to hear from the new ear.

Surgery

The surgery went well. It was a cold and rainy February morning. My girlfriend drove me to the hospital. It was definitely nerve-wracking to get ready for surgery. Back in 2016, I was lucky enough to be a guest in the operating room when Dr. Howard Francis performed a surgery, so I was feeling a little bit squeamish. I had been under anesthesia at least 5 other times in my life, so that thought relaxed me. 

It seemed like as soon as I fell asleep, I woke up again. My girlfriend was there and she told me that the surgeon said that it was a success and that I had perfect anatomy. I was given a pain pill and a prescription, and a lot of after care instruction. 

It was more painful than I remembered as a child. One of my friends who has children of his own is fond of comparing children’s ability to heal to Wolverine. Maybe that’s why I remember my surgery from age 10 to be relatively painless. I only took the pain pills for the first 36 hours and discarded more than 50% of the total prescription. I went back to work after only 3 days off - including the surgery date. 

Healing went really well. I had to clean the site twice daily. I felt some occasional throbbing and weird discomfort that seemed to be internal in nature. I had a weird metallic taste in my mouth for about a week. The hardest part for me was the top of my ear being numb for about 4 weeks. It just bothered me for some reason.

I was really surprised at how many people at work approached me after the surgery and asked me if I heard better immediately. I had to explain that I didn’t have the external device on yet and that would be forthcoming.

Anticipation

As activation date neared, I became much more excited. I would be listening to music or something on the way to work and think about how everything would change. I tried to frame my thinking using the word different rather than “better” or “worse.” Whenever I was the passenger in my girlfriend’s car and I had any difficulty in hearing I would think about how hearing from the left ear could drastically change things.

The entire last week of waiting was just filled with giddiness. I invited my parents.

I also had nervousness about the surgery’s success. I had a bad feeling from time to time that when they activated me, they would find out that the electrode array had come out of my cochlea somehow. I was worried because I broke my lifting restriction at work a few times, with 40 lb cases of chicken. I tried to not brace myself too much or hold my breath.

I was nervous I broke the whole thing when I blew my nose in the first two days out of surgery accidentally!

Activation

I went into activation with a pretty good understanding of what would happen. We would stay away from any complicated programming and just give me something to work with. I would be given programs of increasing volume and instructions to go to the louder programs as my comfort allows. I went into the activation with a good idea that I would probably hate how it sounded. The general idea was that over a longer period of time, my overall understanding would be better, especially in noisier conditions. But I went into this thinking that in five years, I still might not be able to hold a conversation with my new ear and that I may never talk on the phone with it. 

I was even looking forward to how bad it could even sound. I liked the idea of being able to relate to people who have had a longer adjustment period than I did when I was 10 years old.

When my audiologist started playing the different-toned beeps in my head, which were very loud, it was amazing. The perception of sound almost floored me. I’m not one to wear my emotions on my sleeve and I found myself uncontrollably smiling - almost laughing. When she finally turned me on to hear my family’s voices, it was amazing how little understanding there was. This type of information was being presented to my brain for the first time in so long and my brain had no idea what to do with it. It felt more like a feeling than actual hearing. It felt like someone was tapping onto my brain. 

Pretty much, even though I ended up going all the way up to the loudest program on the first day, the levels were still quiet enough to where my brain would 100% prefer the old ear. So there was perceptually no difference. I listened to some speaker’s tapes from fellowship to which I had a transcript and tried to follow along with only my new ear. I could just follow the syllables, and even then I would struggle. I tried Green Eggs and Ham which was a humbling experience. 

The next day I went back to Hopkins and we went to the all too familiar sound booth. My thresholds for my new ear were still way below my old ear. My audiologist did some changes, and gave me even louder programming. This was repeated two weeks later.

First Few Weeks

Early on, when my brain wouldn’t tolerate louder programming, it would only use my old ear for understanding. I would only notice the new ear during loud sounds or stressed syllables in speech. I would practice for 20 minutes or so everyday using speaker tapes and transcripts. If my battery died on my old ear, I would wait until absolutely necessary to change it because isolation can help. The eye/brain/eye connection is interesting. If I am isolating my new ear, I am not a good judge of what I am hearing - I can’t identify sounds well. If a conversation is happening behind me, I can’t even tell if it’s speech or non-speech for a few seconds. But there are some interesting ways the brain works. When I hear something and then I look at what is making the noise, my brain then helps out because it knows what it is supposed to sound like. I noticed this the other day when our dog was drinking water. I heard a rhythmic sound and then I saw Libby drinking. Almost instantaneously, the sound became more clear and more familiar. 

As the programming has gotten louder, I have noticed my brain trying to balance the two ears, and I definitely prefer to have both ears on as opposed to wearing only my old one. I feel like I am missing a richness or a fullness to sound when I take off my old ear. So in that respect, I know that decision has been greatly positive thing even though it’s an indescribable perception.  

Breakthroughs

Because I haven’t been doing very much isolating in everyday life, a lot of progress has been unnoticable. I had a really cool experience about two weeks ago when I was walking the dog and my old ear died. I had the baseball game on the radio. As soon as the battery died I thought that there was no way I would be able to understand a single word due to not having any transcript or captioning. But the context of the baseball game gave me enough information because I totally heard “Darren O’Day” and “out of the bullpen” and also “swing and a miss struck him out.” It was so exciting. I didn’t understand anything else. This is after only a month and a half.

 

Continuing to Practice

It’s hard to practice when living a full and active life but I can tell that it is important. I need to step it back up because it has dropped off considerably. I am also needing to start practice more without transcripts. Having my girlfriend read to me while I alternate between reading and not reading her lips is good practice.