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Your opinion on cochlear implants

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In reply to @Deaf_piper

Surgeons are quite happy to follow the recommendation of audiologists unless there are contraindications to doing so. There is a reason why audiologists are part of the decision making panel: hearing is our area of expertise. We are the professional for this area.

I am a 65 yo man who is a HUGE music aficionado, despite (or perhaps due to) being deaf in my right ear since birth and progressive loss in my left ear (20% initially, then 40%, then 70% and now maybe more) eventually leading to complete deafness due to congenital condition. I investigated a and was told I was a good candidate.

Upon further investigation, I discovered that the CI essentially kills what is left of the hearing in the ear and requires you to re-learn how to interpret the sounds input to your brain via the CI. Upon confirmation with the UCLA doctor that, while CI would allow me to hear sounds much better, they would NOT be the same sounds, I made my decision.

In view of how well I hear sounds AS THEY ARE via the Bluetooth connection between my phone and hearing aid, I informed the doctor “if I listen to a David Gilmore guitar solo, it MUST sound like David Gilmore, not be INTERPRETED as David Gilmore” so I will wait until the hearing in my left ear degrades to a point where I can no longer hear the music via the Bluetooth connection even at the risk on CI perhaps not being an option, at which point I will accept the “I’ve heard enough.”

Just by 2 cents but they are MY ears!

In reply to @Hearing_Potential

@Hearing_Potential said:

Surgeons are quite happy to follow the recommendation of audiologists

What I have seen is the audiologist does hearing tests. Gives the go ahead based on hearing for the doctor to do further testing. These tests ordered by the doctor will give the yes or no for . The surgeon has all the say so about the patient and the surgery. The patient will be released to the audiologist when the surgeon says the patient is ready. This is what I have seen in the USA.

In reply to @ipesq

@ipesq said:

Upon confirmation with the UCLA doctor that, while CI would allow me to hear sounds much better, they would NOT be the same sounds, I made my decision.

From my experience this statement is incorrect. The doctors don’t know what patients hear. They fail to explain how the brain is plastic and conforms hearing as needed. My bilateral CI hearing is normal hearing as I can tell. I can talk to an old friend on the phone I have not talked to in 20+ years and recognize their voice. CI is not perfect but it’s much better than you are thinking.

In reply to @astrohip

I’ve heard a warning tone for the battery maybe twice. But I still strongly prefer to keep track of my state of charge. Prior to the CI and Phonak Naida Link M I had KS10 HAs. The app would indicate the SOC to within 1% (although it was not that accurate). In addition, the LEDs on the HAs showed 4 levels of charge during charging via 3 colors plus flashing or solid. Unfortunately, my hearing deteriorated, which led to CI surgery. The KS10s also had some occasional battery issues, even after they were replaced under warranty.

In reply to @ipesq

I am ( in left, on right) I have music background and I don’t feel that hearing bimodally is deteriorating for my music experience. On the contrary, I hear music as fuller, more giving a pleasant goosebumps effect.

Indeed, hearing through CI only is hard, especially without proper rehabilitation, but that is no problem if hearing from it blends with hearing from HA.

No regrets from getting a CI, even from music standpoint.

In reply to @ipesq

@ipesq said:

In view of how well I hear sounds AS THEY ARE via the Bluetooth connection between my phone and hearing aid, I informed the doctor “if I listen to a David Gilmore guitar solo, it MUST sound like David Gilmore, not be INTERPRETED as David Gilmore” so I will wait until the hearing in my left ear degrades to a point where I can no longer hear the music via the Bluetooth connection even at the risk on CI perhaps not being an option, at which point I will accept the “I’ve heard enough.”

You have been misinformed. I’ve been a music lover since I was a kid. I have a collection of 3,000 albums & CDs. I had “normal” hearing until my 30s. I now have two , and STILL listen to music, and it still sounds great. I listen to my old music, I listen to new music, it’s all great.

I’m not hearing what my brain THINKS is music, I’m hearing music. Your surgeon could not have been more wrong.

Is that surgeon’s view outdated based upon earlier processors where sound was less natural? Or was that view never accurate?

The idea that one is hearing music “as it is" through a severe/profound hearing loss is also false.

Where I am, unless there are strong anatomical/surgical reasons why one ear won’t be as successful, our surgeons take patient preference into strong account. When someone has been sound deprived binaurally for a long time outcomes aren’t as good and we used to just assume that would be the case with monaural deprivation, but it’s turning out not to be. The auditory system is integrated (left/right) pretty quickly, so it does make sense that function on one side supports outcomes in the other.

If I were the OP I would implant the right ASAP, but then history of progression would probably play into how quickly I’d move forward with the other side.

In reply to @Raudrive

I think this poster is referring to the quality of pitch information through a which is very different to that possible with natural hearing. CI users are able to differentiate between a maximum of 6 - 8 different pitches at any one instant in time. Sequentially this can be between 120 and 250 pitches. Performance varies between recipients.

Natural hearing when “normal” allows for the differentiation of 20,000 different pitches for musically trained adults and 10’s of thousands for the musically untrained. The lack of pitch differentiation doesn’t matter so much for speech information, but for music which is what the poster is referring to, the quality of the sound is very different.

The limitations of CI technology are due to the spread and overlap of electrical current delivered by electrodes in the fluid environment of the cochlea, rather than physiological limitations of the hearing system or electronics of the devices themselves. Limiting current spread while delivering sufficient current for hearing is one the biggest obstacles to overcome in improving CI design. That is why alternatives such as using light-based stimulation of cochlear neurons are one of the options being explored as an alternatives to direct electrical stimulation.

New Audiologists have doctoral degrees in the USA. What you wrote was literally the surgeon listening to the recommendation of the audiologist. Just because you as a client don’t see the collaboration doesn’t mean that isn’t happening behind the scenes.

Edited

I am published author in this area. What I wrote is written from my own personal studies and was summarised in my master’s thesis. You can read one of many open access papers on this subject and find the same information. For example this 2004 review: Music Perception with Cochlear Implants: A Review - PMC5

And you can run my post through an checker to see whether it was written by a human or not if you’d like. If I use AI I will specify that it was used in the post.

Edited

In reply to @Raudrive

HearingPotential doesn’t need for that.

(Edit: Just to be clear, I was saying that they don’t need AI to write about .i realized after the fact that if someone thought I was an asshole they might read it as: they don’t need AI to write nonsense.)

@Neville said:

HearingPotential doesn’t need AI

Fair enough, thanks.

I still don’t agree with his assessment of how well patients hear. He is cutting the human part out of the equation. Telling those with CI what they can and can not hear is questionably foolish IMO. Similar points of view have held up potential cochlear implant patients due to fear when it’s not all the facts.

I can’t argue with him, I don’t have the book knowledge but do have experience that I enjoy sharing as the truth.

Yes, I agree that we cannot focus on the limitations of the device, we have to look at the ultimate user outcomes because the brain is, simply said, cool as hell. I also think there just generally hasn’t been the emphasis on musical training for users that there has been on language training.

BUT it’s something I’d have to dig into more. CI work is really siloed into specialised centres Canada, covered under our universal healthcare, and if you live outside of certain big cities you just don’t really get to play even if you want to. So it’s not something I’ve spent much time on despite the basic coolness of the topic. I have a few patients, but I send kids away for bilateral CIs and just never see them again.

In reply to @Raudrive

I should make it clear that it’s not my assessment, it is what the published research says and it plays out in real life. Your experience is your experience, but as with all things related to hearing loss individual outcomes vary greatly. I’m also specifically referring to pitch perception, not speech recognition. Outcomes for users are much better for speech recognition on average than they are for pitch discrimination. It is important to give people realistic expectations based upon the evidence available to us. Outlier performance is a real thing too, which is why anecdotal reports of terrible or really excellent performance need to be framed within the context of a broader user base. I hope that makes sense.

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