Yesterday I was approved and some questions

Great questions! Overall, for your technology comparison among brands, I HIGHLY recommend that you reach out to those you are considering (Cochlear and AB) and zoom with representatives. I had multiple zooms with each and asked lots of questions! It was very helpful in explaining the technology better than I could. There are nuances. For instance, the new Cochlear boasts a tech that they say is first ever, but it is something AB says they have had for for a while - just calling it something new. Others here dispute that, and I am not knowledgeable to go into the specifics, but it made sense when I talked to the AB Rep - lol. I have and AB - in my 3rd year - and have the accompanying Phonak Marvel Link and love how they work together using a single app. AB is the only brand so far who has the CI and HA truly “linked” and working together. Cochlear “works” with several brands, but they are not truly “linked”. I’m sure that will change very soon. It is a constant up and down for who has the most recent tech upgrades, but they all “work” to help you hear. It helps to look at how you live and what situations you care about hearing and talk to the reps to get a sense of what might work best for you.

1. I wear glasses. I just took off the side ear support until my ear healed enough to put it back - no problem. If you have an old pair of glasses, take the bar off and bring it with you to wear post surgery. I have no trouble keeping both glasses and CI on my ear.

2. AB (and maybe cochlear?) offer ‘Points’ which you can use to purchase a hearing accessory like a Roger, or activity battery (for swimming). Up until a year or so ago you could use all of your “points” to get the Marvel Link HA. But the other brands cried foul saying it gave AB an unfair advantage, so you can no longer get the Link with your point - need to pay out of pocket. My understanding is that the HA is often discounted so it might be less than the list price you see. That is a question to ask the AuD at your CI hospital.

3. yes and no - as I mentioned in my first para. They “work” with several HAs, but are not truly linked at this point. Phonak and AB are owned by the same parent company and therefore work together on things.

4. You would do better getting more accurate info on this directly from AB. I do know that a new processor is likely in pipeline and we might see something in 2026. Those who implant now are being offered a free processor upgrade when it is available. Things usually land in Europe first due to shorter approval times.

5. Not sure on this - honestly don’t remember. Ask the surgeon or AuD at your CI hospital. They can often give you something to relax if you struggle!

Good luck with the process, and please do not hesitate to reach out again here - or to message directly. I have been happy with my AB and with the customer service support. Any brand will help you communicate better!

1 When I was activated I took the arm of my glasses off for a couple of weeks until I could manage

3 yes the Cochlear Nexa does has have direct bimodal streaming, with the GN aid

4 The Cochlear Nexa is the most current up to date technology. It was released just last year.

5 MRI & CT are just on your head only. They are looking for abnormal bone structure and nerve placement.

I agree with @joanhawsey you need to reach out the the reps from both companies with questions. 1. Asking about ongoing costs for replacement parts? Activation costs? Mapping costs? Mapping is a lifetime cost to you. Technology questions you might have while this group is very knowledgeable group we live in different countries. Resulting with different answers

Don’t feel bad if you post phone this procedure, there is absolutely no pressure after your evaluation. I put it off for 18 months, in that time I did an awful lot off research.

Good luck to you on your new hearing journey. Come back and let us know if you have more questions.

@joesan ask your AuD to help you organise this evaluation. It’s a 2 hour long thorough testing of your hearing. Both with HA’s in then out. Do take a bottle of water with you.

Make a zoom appointment with representatives from the 3 companies. Do some research first and have a list of questions you want to ask them. Ask them to send you an information pack. Ask each company about ongoing costs as these cost are for your life time. Your surgeon should be able to help with the insurance process, or the CI company can help with the insurance process also. Good luck.

Joesan. I see you are in California so you may have insurance, VA or some other support for this. I can only speak on my experience and am IN U.S. Chicago and currently insured with an HMO through BLUE Cross.

With my HMO everything starts with your primary doctor. He/She refers you to a implant surgeon IN NETWORK. The surgeon likely works with a clinic and audiologist. The Audiologist starts the evaluation and, at that point the surgeon controls the entire process, referrals MRI’ etc.Audiologist works in the same group and runs all of the mapping etc.

I got referral from my primary. Made appointment with surgeon who was in clinic, audi did testing I am approved Go back for second appointment to discuss surgery process, scheduling, discuss with manufacturers etc. They are in network so no further approvals are needed. Seems too easy but took hours to figure out. PPO, Medicare, Medicaid, VA may be similar. If you would like to pm me or arrange a call, I am happy to discuss with you. IN Network is the imperative word. You will be denied and pay appointments if you do not play by their rules, so is best to make the calls and find out where to start. That is my story. Good luck.

A few days late on this and I was seen for second appointment on 2/9. My wife attended and only hearing testing was with BTE aids that Audi set up in sentences with noise and without. Was pretty tiring but not long. Terrible failure as best was without noise with both ears and was like 28%. Individuals with noise was under below 10% t0 15%. She also did the psychological and aptitude test -counting backwards, words with the letter F starting, etc. I can ace that. Most of the equipment she showed me was AB and only thing she mentioned about Cochlear Nexa was that she was not a fan of the Kanso as it continued to fall off. There were some questions I did not ask or may be better for the surgeon who was not there that day. Maybe someone can offer some add.FYI, I did talk to an AB Rep and the email for the CA had no number, impossible to get a human on CA number in Denver and the rep did not respond to email -bad.

1. Audi showed options for the AB processor and link. One was the water protector and it was some plastic box you had to put on if you were in a wet environment. Seems pretty fragile. The Nexa info catalog has one for deep dive and salt waters but at the beginning brags that normal life wet, showers, rain, pools are pretty IP68 waterproof. They have the box you put over in ocean or diving. What does their IP68 really mean and does the AB have it. I got this crock of crack when I got mt Lumity Life that audio with videos “could not kill. I was in nothing but rain while fishing and one crapped - I have silicone slim tip. .
2. The NEXA New Nucleus implant - not processor. I consider or think of the implant having a chip, just like a computer that has Intel Celluron, I3, I7 etc that can process better, faster etc. Also it has electrodes that go into the coch.Has anything improved in the new CA implant - not concerned about the “smart” stuff. Does the new engine or electrodes really make me hear better?
3. I did ask the AB rep about their product and asked how old was their software based on both processor and Naida Link. I asked when they were invented or updated. I asked if I was correct thet the Link was Marvel and that hearing tech was going on 9 years and the last update if the hardware was in 2022 but chip engine has not changed and it was originated 20+ years ago. She advised that they have the updating tech better than the NEXA 24 years ago and no need to change that. I asked her crystal ball on the next thing that our friends at Sonova were updating. She thought a new processor “might come up in 2026 but now not sure. My Audi says same. Any thoughts on all? I have a med issue as well that I will make new post on and keep you updated.

Sorry for the late response and where I am at. Due to some medical complications outside of the surgery itself, and if we have any medical interpretation members on board?

First, I am diabetic and have not done spectacular with my management. Surgeon advised that needed A1C needs to be undet 7.0. Was nowhere near that. My last physical in December my Primary HMO Doctor advised that I needed to work on this or I would eventually go the way of my late mother. Eating whatever the hell you want and shooting more insulin is not the answer to this disease. Cochlear evaluation was second eye opener. Back on good diet and exercise and will pull A1C today. Should have vast improvement.

Secondly, as a protocol the Cochlear Surgeon had an MRI done and there is an abnormality that he wanted cleared before doing anything. The end summary is as follows.

“FINDINGS: Dedicated temporal bone imaging does not demonstrate abnormal T2 signal, mass, or abnormal enhancement within either inner ear, IAC, or CP angle.

Imaging through the brain does not demonstrate an acute infarct. There is moderate generalized volume loss and mild microvascular ischemic changes, with the volume loss advanced for patient age.. Chronic cortical encephalomalacia involving the lateral aspects of the right inferior parietal lobule and right temporal lobe is present, consistent with prior right MCA ischemic injury. Focal T2/FLAIR hyperintense signal involving the left inferior temporal gyrus is also present, without obvious volume loss or enhancement (image 7 series 4 and image 5 of series 9). There is no pathologic intracranial enhancement, pathologic extra-axial collection, significant focus of gradient susceptibility, or hydrocephalus. The craniocervical junction and major vascular flow voids obtained.”

Abnormality left lobe. Last sentences look like nothing wrong that would impede surgery, but Cochlear Surgeon wanted my Primary clearance. Met with him 10 days ago and he advised that whatever was does not look serious but he wanted to send it to a Neurological Surgeon for opinion if anything warranted. No response yet and his office is very poor on followup calls and emails in their portal. If updated portal twice and left 4 messages for nurse who controls referrals, etc.

It turns out a game of roadblocks and is frustrating and ends up being countless hours with coordination and waiting hours on the phone. Such is the status of the out of control lawsuit paranoia, astronomical insurance mriced, medical system in the USA. Will update on status and choice between AC and CA - maybe between all of this delay will be a new breakthrough form AB to consider.

Thnx

Wow - so frustrating to wait for interpretation of important medical testing. I hope they get back to you soon and that you are cleared for CI.

I am now approved by the audiology/surgery group that assessed my candidacy and may well go with them. There is one more local surgeon that I will discuss with next week for an ultimate decision and who will be the most qualified at mapping. The first group has tentatively scheduled me for 5/22.

Big question now is Advanced Bionics or Cochlear. I was hoping that Cochlear/Resound would soon come up with a Bimodal hearing aid that would be similar to the Phonak Bionics Link. Or that Bionocs would introduce something after the AAA conferences. Cochlear already has new tech out with the Nexa and might be a slam dunk but I just read that GN just sold out and that a link-type device from Cohclear is miles away. Ampliphon was previously Miracle Ear here and they were a pretty slimy newspaper spam calling operation.

Hope something new comes along very shortly but probably won’t wait for the “Great Pumpkin” to arrive. Will keep all of you updated. Thanks..

I think you would benefit from having a video conference call with reps from the companies you are considering. Just reading your post you sound a bit confused about direct streaming. These reps are very knowledgeable people about the processors their company has currently available.

Right now, my Blue Cross HMO will cover 1 implant.

I have been set for surgery on May 22. I have spoken to the two local surgeons and audi’s and Bionics rep. At this point, I have decided to go with Cochlear Nexa and get two processors. I will get 1 Kanso and 1 traditional bte. At some point, I do expect that Cochlear will match with a similar hearing aid technology similar to the Phonak Link and it is ready for LE, Aurcast, etc for my other ear sometime in the future.

IF Phonak/Bionics, Sonova happens to get off of their high horse stubbornness and, by remote chance, came out with a new breakthrough product before I have surgery, I would consider it, but not holding my breath. Seems that they are content to use 8-9 year old Marvel technology and ride out all of the classic bluetooth, roger stuff that has been their cash cow for years, focus only on ric hearing aid technology…..and I do own Spheres. Done babbling.

Will keep you advised.

For your consideration if the link is important for you: There are murmurings about a new AB platform coming out this year, but nothing official, so your rep can’t talk about it. The big “hint”per my AuD is that they are offering a “future proof” sort of agreement for those getting implanted now. If you go to a clinic that offers 2 processors, you can leave the second one boxed up and exchange it when the new processor comes out. There will be a new linked HA as well. My insurance allows me to upgrade after 5 years of implantation. I’m at 3.5 now and so I plan to upgrade when I can. Having them linked seems to make the result that much better than each on it’s own.

Hey Joan. Thank for your input.

Are you saying futureproofed meaning if they come out with a brand new implant - not processor that they will pay for a new surgery? I did not get that message.

The implant itself is my concern. I agree thatthey are the only ones that link and I would like that feature, though my audi says it would be a few months after being turned on and getting practice, learning, acclimation to an implant.Yes, she advised that you ger two processors.

I don’t really want to go through two surgeries or waiting for Phonak or Bionics to come out with the next great thing.. It is kind of like Linus and Sally waiting for the Great Pumpkin that never comes. I think that if there is a breakthrough, it will be announced at the national conferences at the end of this month. If so, I will possibly put off.

Thanks