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Value in CI evaluation if you don’t want a CI?

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Hi folks, new to the forums and just generally trying to get my health care back on track this year. Part of that is new ’s (decided on Phonak Nadia L-UPs) and finding an audiologist that is familiar with my level of hearing loss that I’m comfortable with (still in progress).

My question here is how much value would I get out of doing a full evaluation even if I have no intention of getting a CI now or maybe ever? I’ve heard it is a more in depth evaluation of your hearing which I would like to have if it could be useful for HA fittings or for future reference if CI tech changes to the point I would get it.

I have been told I’m a candidate in the past but none of my audiologists have pushed it on me once I said I wasn’t interested so my knowledge is very limited and about 10 years old :smile:

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The evaluation is both medical and audio tests with an and an audiologist. It’s geared towards you getting implants.

The evaluation will also tell you how well your aids are programmed in comparison to your hearing loss. What you should expect out of the aids and also your hearing.

There will be lots of questions about your desires to have implants and why you need them. They don’t want people getting implants that are not willing to put in the effort to learn how to use them to be successful.

You are doing great with hearing aids after looking at your . Our hearing losses are not that different. My hearing was still getting worse and that is why I went with CI. I could see being totally deaf and not being able to communicate with family and friends. My new grandson was very important to me.

You are still young with lots of life to go. CI has gotten much better just like hearing aids over the past years. They have changed my life for the better. Waiting on Cochlear to get hands free calls like Phonak. I loved that feature.

If you’re interested in learning more about your hearing, I think there is benefit in a eval.

In reply to @Raudrive

@Raudrive that was very helpful! I have an audiologist appointment in a month and will discuss with them. I mostly want a comprehensive understanding of the state of my hearing today so a full evaluation may be overkill. I do have a progressive loss but it’s a gradual one and as you note I’m still getting a lot out of my hearing aids so it’s not a quality of life issue for me yet.

@Heather_R said:

I mostly want a comprehensive understanding of the state of my hearing today

Word understanding scores with and without your aids might be interesting for you. Set a baseline if you haven’t done them before.

Understanding that as you lose word understanding it will more difficult to adjust to if you ever do go in that direction.

In reply to @Heather_R

The evaluation is beneficial. You’ll have a test such as speech audiometry (eg. - Word Recognition Score) which tells about maximum possible understanding of words (in %). With hearing aids you didn’t the best score you’ll achieve. The way to upgrade WRS score is only CI.

Maybe you’re afraid of postoperative loss of hearing of bass in operated ear. But you’ll be probably qualified for electroacoustic stimulation, with shorter electrode with much less risk of damaging low tones areas of cochlear. With that in operated ear you may hear bass in acoustical way (such as in ), but your high pitch will be provided by electrical stimulation from the same unit on the ear.

I don’t want to pressure you to operation. Just try to keep you more informed. I am almost 35, and feel a some lost chances mainly because I wasn’t eligible to implantation before my 20’ despite the same level hearing loss.

Cheers

Thanks everyone, I have an appointment with a new audiologist in a few weeks and will bring this up with them. Previously I’ve had decent WR scores (better than my would suggest) but it seems to have fallen off a cliff in the last few years just based on difficulty in conversations and that is definitely something I want to get tested again to see where I currently stand. I spent two years with my left ear unaided during the pandemic and that probably didn’t help matters :woman_facepalming:

I do have brand new now in both ears which are helping a lot and I feel like some of it is coming back. When I got them the fitter did do a brief WR test and I didn’t get anything except hotdog and baseball :flushed:. I do wonder if my old scores were so good because I was testing yearly and had the word list subconsciously memorized from when my hearing was better :smile:

@Heather_R said:

but it seems to have fallen off a cliff in the last few years just based on difficulty in conversations

This sure sounds like my hearing the last 2 or 3 years before I got implants. It didn’t seem to matter what was done to the aids my understanding continued to get worse.

The evaluation will answer so many questions. Some you might not be aware you needed answers to.

In reply to @Bimodal_user

@Bimodal_user said:

with shorter electrode with much less risk of damaging low tones areas of cochlear. With that in operated ear you may hear bass in acoustical way (such as in HA), but your high pitch will be provided by electrical stimulation from the same unit on the ear.

Here in Australia the short array hasn’t been use for 12-15 years now. Recipients were experiencing far to many problems with the short array. These recipients were having to be reimplanted with a longer array. Hence why it’s not being used anymore.

It’s something new for me. Maybe Cochlear has this information on their papers. However, isn’t they were reimplanted, because of losing the rest of their hearing over time?

In reply to @Heather_R

Some observations from one who has had a Medel implant for nearly 6 years now. And I’ll be 85 at the 6th year point. I chose to have my weakest ear converted. The other ear is in the severe loss range now and I just acquired a new Phonak Nadia L90-UP aid - Phonak’s strongest hearing aid. When I got the I lost all “normal” hearing in that ear. So at night and the hearing aid out I just have very weak hearing from that ear - but at least it is something in case of an emergency.
But here’s the key thing. With the newest and strongest hearing aid Phonak makes in my natural ear I now can hear nowhere near from that ear what I hear with the CI.
With respect to the CI side there are 12 little electrodes in my cochlea, which is a small “snail shell” contraction that is the same size as it was at birth. My audio booth work is to see what word recognition scores I get with male and female speakers and then speech in noise score work. Of interest a good part of the challenge is in your brain. By that I mean that if the speaker was raised in another non English speaking country his or her word pronunciation of English words is different from what your brain is accustomed to and you will struggle to recognize what is being said. I still need to see the speaker’s lips move and of course covid masks were deadly.
But as of the last couple of weeks with the new hearing aid I realize I am considerably better off with the implant. Yes it will take you up to a year to get accustomed to the implant but in my view you will be better off in the end.

@rsinclair123 thank you for your detailed perspective! I’ve been doing more research since my original post and I am pretty sure a is not in the cards for me at this time due to my current lifestyle and satisfaction with what I am getting out of my current but I’m keeping an open mind.

I can understand not getting a , especially if you are old enough that the anesthesia is risky. I had a CI evaluation about five years ago. I didn’t qualify then, but probably would now. I am using mics and captioning equipment instead of taking the risk. The evaluation I received was only a rejection based on too much word comprehension. I received no info that would be helpful. My conclusion is that the risk of dementia following anesthesia isn’t worth it. I recommend my audiologist, Jill Rosenberg at Audiology Services in Belmont. She understands the technology better than most audiologists.

In reply to @Heather_R

@Heather_R the theory from audiologists and surgeons today, is the sooner the better. By sitting back and waiting until your hearing loss is so severe you struggle to communicate. By doing this you may not get as good a result as you’d like. If you qualify for a CI now you could possibly get a really good result. That’s the theory at least.

@carolagate anesthetics are a risky procedure for any age, not just older folk. Neonates are very fragile little people they are risky to anesthetize.

Anesthesia has gotten notably better and safer over the years. I remember feeling sick and hungover after surgeries from long ago, but feeling remarkably perky after more recent surgeries. For safety, I’ll link to an article. In the 70’s, 1 in 10,000-20,000 died as a result of anesthesia. Now it’s like 1 in 200,000.
That’s .0005%.

It varies a lot depending on the surgery and how healthy the elderly person. For big surgeries (like open heart) and somebody not in good health, yes, it’s common. In lower risk surgeries (yes, I think qualifies) and somebody in decent health, not so much. I’m thinking most surgeons would not be eager to do an elective surgery on somebody they thought was high risk.
Postoperative delirium in the elderly: diagnosis and management - PMC.

I’m recently 44 years old and in good health overall so the surgery itself isn’t much of a concern for me (apart from my hesitation of having any elective surgery when my quality of life is currently very satisfactory) but this is all very good information to know for others that might come upon this thread.

Another consideration that I have been researching is that my hearing loss was moderate to severe when I was diagnosed at 3 yo and dipped into the profound range at the higher frequencies 30 years ago. I worry that my ability to process sounds at those frequencies is minimal if at all, even with a .

We are part of a small group at our church. We meet 40+ times a year for dinner and fellowship. One of our members has been significantly hearing impaired for decades. He recently got a in his worst ear. He went from not really hearing much in our group setting to hearing most of the conversations well. He is older, early 70s and he wishes he had done the CI years ago.

The CI has made a big difference in his quality of life. It has helped his wife as well as he can now hear her even when she is in the next room.

In reply to @Bimodal_user

Deaf Piper is correct. I considered the shorter electrode to preserve my normal range low frequency hearing. HOWEVER if I were to lose that range I would need to be re-implanted with a full length. I chose the full length at the start and DID Lose my residual, but what I can hear with the Advanced Bionics is so much better overall, and together with the linked PHonak in my other ear, I have zero regrets.

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