Cochlear Implant - awaiting insurance approval; questions/advice

So my hearing on the left is profound loss, stable for the past 10 years or so. Although it is -95 to -100 flat (zero word recognition even with aid) my right ear has been great…until 2 years ago. That ear has some tones that are not bad -30 and a couple that drop to -55..BUT I do have 100% word recognition on the right - when it is working correctly (some periods I lose hearing almost completely, for a day/week or longer).

Plan (assuming insurance approves) is to move forward with Cochlear Implant next month. That way I am on the road to hearing on the left - then work on figuring out the right of course. (It’s a quick plan as I just finally got off my .. to get to the specialist. First appt was Sept 22nd!..it’s a lot.)

Highly ranked audi - answered all questions but had no recommendation on Cochlear Americas or Med El. I did ask (since I read here) about Med El longer electrodes promoting better results and more natural hearing. She said that new studies are not finding that - but said they are good.

Dr implants both. Doesn’t give a preference. Both Dr and Audi did say that in my area/vicinity Cochlear has a broader support network.

I should add -hearing loss on my left due to Meniere’s; which also has significantly damaged the vestibular function.
Some questions:

Should I push more on the Med El or Cochlear implants? I am leaning towards the Cochlear simply since there is more support in my area.

I do have one good ear (o’k..better). Will that make it easier or harder to adjust/train my left ear to understand what I am hearing after implant?

I know that I need someone to drive me home after - but is it REALLY necessary to have someone stay overnight with me? Or as long as I have someone close by to call?

Audi has agreed to reprogram my Oticon More 1 after the implant to use in my right ear (currently not aided). But as it will not pair with Cochlear at some point would need to move to a Resound.

Assuming the left ear gets trained to hear, and my right one has A hearing aid - is it really necessary to have the two “pair”?

And a fun one..maybe harder to answer…from the CT scan something about my bone in that area; jugular bulb close to cochlear will require “more drilling”. Eek…The surgeon has advised minimal pain after the surgery so she recommends OTC pain killers. So for those who have had it, do you think OTC is enough? Would “more drilling” cause more pain? Should I push harder between now and next month for better pain control option?

As important, for any who have gone through this, if you have any tricks or learnings that I should incorporate please feel free to share. The questions above are mine now. But I have learned in life “you don’t know what you don’t know”. Many of you KNOW so would love your insights.

Yes, had the initial eval; just had the follow up appointment confirming that testing and CT showed I was a candidate. Neither the audi or dr mentioned AB - not sure if that is because they don’t have a lot of support around here. Med El and Cochlear are the two that the dr implants most; but leaning more heavily to the Cochlear. I am going to ask if it will be the new Nexa system (believe Yes because audi mentioned newly released technology).

Audi said that the success is based on the rehab (so up to me).

I will ask here after implant before activation for any/all best practices. (If insurance approves) I am thinking of using my 2 weeks PTO post activation so that I can focus speifically on rehab - but audi actually said that continuing to work in my normal environment is also key to rehab.

@bcarp said:

Profound hearing loss for 10 years, then a cochlear implant? Not sure what to expect of that. With the neural pathways not used for 10 years, rehab might not be as good as you might otherwise expect. Have you had this counselled to you by the treating team?

Not necessarily, I have got CI after 20 years of complete (unaidable since SSNHL) deafness in my left ear. In Facebook group there are people who get it after 30 or even 50 years with good outcomes.

OP has better prognosis, because his future CI ear isn’t totally deaf.

@nicmger said:

Plan (assuming insurance approves) is to move forward with Cochlear Implant next month. That way I am on the road to hearing on the left - then work on figuring out the right of course.

You didn’t mention whether you have Medicare (or even if you are from the US.) If you have Medicare, they will pay for almost everything, (See below.) I had CI surgery on L ear in Jan with activation in Feb.

I chose Advanced Bionics (unfortunately, their app is primitive,) plus a Phonak Naida Link M HA with earmold. Perhaps Cochlear would have been a better choice.

My treatment was at Mayo Clinic in Phoenix & Scottsdale, AZ. The list price (not including reprogramming last week) was $102,143.98. Medicare paid 33,099.07 and my secondary ins. paid 3,565.40 (including for a mold for the R HA.) I paid nothing other than for travel from Prescott & for lunch.

My surgeon is ordering a CT scan to check whether the electrode moved.

I do not recall much pain except nausea. (No pain pills were prescribed.) I lost what was left of the previous day’s supper on the ride from the hospital to my son’s house and I lost the next day’s breakfast going home the next day.

My implant still sounds buzzy and metallic but it helps me hear, especially higher frequencies, such as crickets & women’s voices. Indeed, I hear crickets & birds through the implant better than my wife does, Without the implant, my L ear is almost dead. I have only a little hearing in my R ear without the HA,

For training my implanted ear, I listened to streamed articles from the NY Times, usually with just the CI. Most of these are “read by an automated voice” and they are easier to understand than most human voices. I hear considerably better via streaming than by using the microphones on the CI & HA. I have trouble with multiple voices or in noisy environments,