Tuesday, January 09, 2007

Cochlear Implant 3


Officially, there are no rocks or other impedimenta in my cochlea, even though my head is as round as the Minnesota heads Charles Schultz immortalized in "Peanuts." Looking at the scans, you'd think they'd taken photos of a bowling ball. The diagram above is what the surgeon handed me yesterday with his notes regarding the possible risks: infection (I'll need pneumovax vaccine), weakness in my facial nerve, imbalance, and failure of the device itself (1% need to be yanked and replaced).

Officially now, too, they have the evidence on paper that my auditory nerve is not dead or too seriously disabled. I got maybe 50% of one batch of monosyllabic words right with my right ear helped along by a hearing aid, and 94% with my left ear, ditto. So it's working. If it were not working, all the cochlear implants in California (where they make a lot of them) wouldn't do a thing.

A beautiful Chinese resident really rattled my brain (I could hear it sloshing in there--yeah, really!) when she was twisting my head to see if I would still get vertigo from sharp, sudden movements of my head, and I didn't. When I was first losing my hearing, even tipping my head down to peel potatoes could set my head spinning. I'd have to lie down until the spinning stopped. Then I'd go throw up, and after that, I'd go finish the potatoes.) I also could not eat movie popcorn without risking an attack of vertigo--too much salt--but now I can. As my hearing has gone south, the vertigo has disappeared, too.

They told me yesterday, too, that officially I now need a permission slip from my primary care doctor for them to perform the surgery. (She is a marvel, by the way...she got her B.A. from Barnard College, then a law degree from Yale, then an M.D. from Yale. She's one of the best doctors in D.C., and she speaks not only English but Hungarian--not that that's going to do me any good, but she has a very lively mind. She always notices things: what I'm reading, the color of my new glasses, etc.)

And I told them yesterday officially that yes, I did want to get a cochlear implant. The beautiful Chinese resident said, "Why do you want a cochlear implant?" To which I replied, "Why not?" When cochlear implants first came out, they had one channel of sound. The contrast between the number of natural channels of sound in the human ear and the one in the implant seemed too great. But now there are implants with 22 channels of sound. You don't need to have all of the channels to make a huge difference in what you hear. So why not go for it? I'm looking forward to the experience of learning to hear with the bugger.

One more barrier to leap is the psychological evaluation, which is tomorrow. On the questionnaire, they had items like "In the past few days, have you felt depressed or suicidal?" and I checked "yes." Well, it was right around Christmas. Of course I was depressed (though not suicidal)! Isn't everybody? Tom Lehrer had it right in his "Christmas Carol":*

Christmas time is here, by golly,
Disapproval would be folly,
Deck the halls with hunks of holly,
Fill the cup and don't say when.
Kill the turkeys, ducks and chickens,
Mix the punch, drag out the Dickens,
Even though the prospect sickens,
Brother, here we go again.

On christmas day you cant get sore,
Your fellow man you must adore,
There's time to rob him all the more
The other three hundred and sixty-four.

Relations, sparing no expense'll
Send some useless old utensil,
Or a matching pen and pencil.
Just the thing I need! how nice!
It doesn't matter how sincere it
Is, nor how heartfelt the spirit,
Sentiment will not endear it,
Whats important is the price.

Hark the Herald Tribune sings,
Advertising wondrous things.
God rest ye merry, merchants,
May you make the yuletide pay.
Angels we have heard on high
Tell us to go out and buy!

So let the raucous sleigh bells jingle,
Hail our dear old friend Kris Kringle,
Driving his reindeer across the sky.
Don't stand underneath when they fly by.
* http://www.lyricsfreak.com/t/tom%20lehrer/a%20christmas%20carol_20138380.html

Another item they asked about is "How many alcoholic drinks do you have every day?" To which I replied, "As many as it takes." Well? What do they expect? I can't listen to music!

Anyway, if by some miracle I pass this last hurdle, they will send me an email as to when they will perform the surgery. The surgery itself will be an outpatient procedure and take about one hour. The surgeon will cut a flap in my scalp behind the back of my right ear, drill a hole through the temporal bone, thread the electrode through the hole into the cochlea itself, where it will curl up next to my auditory nerve, and then sew everything up.

After the surgery, we'll wait about a month to 6 weeks for the incision to heal, and then they will start to tune me in. Thus, I'll have a metal implant a little smaller than a flattened bottle cap under my scalp; the electrode leads off this into my cochlea. On top of my scalp, there will be a round thing with a magnet attached to the processor (which looks like a very big hearing aid). The magnet will grab onto the bottle cap thing under my scalp, and transmit sounds via the processor behind my ear, through the electrode, and directly to my brain. It's all done with electric impulses, and part of the reason why the processor is so much bigger than a regular hearing aid is because it has to hold 3 batteries at a time instead of just one. A rechargeable battery unit comes with the processor, also. I had my choice of colors for the external parts: black, brown, that new titanium steel color, tan (the boring old hearing aid color), pink, and blue. I got the steel color. There's also a little panel on the processor that comes in other colors and patterns. I definitely did not want the leopard print!

These pictures are from the Cochlear website: www.cochlearamericas.com/Products/23.asp


the electrode with the 22 channels (l), the processor and external magnet (r)

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