Ben's request for input on simultaneous or sequential bilateral CI's

[Guest guest]

Hi, Ben, and all. I was faced with the same situation as you this

year. I had full hearing until April when I was ill overseas and

given an ototoxic antibiotic which " nuked " my hearing on both sides.

My family evacuated to the U.S. to deal with my hearing loss and over

the course of the next months, I went into hyper-research mode to

verify what happened to me and what were my next steps toward

regaining my " life " . It was a difficult Summer, coming to terms with

my disability and struggling to communicate, but I was approved as a

candidate for CIs, and because of my " insurance " situation, I was

approved for one or both ears to be implanted.

My desire to do simultaneous bilateral implantation made perfect

sense to me for all of the reasons you have been considering as well:

insurance deductible paid once in same year, one hospital charge and

one recovery time, and one effort at " rehabbing " after activation to

maximize the effectiveness of the speech processors. However, my

surgeon had a couple of hesitations that I didn't fully understand at

the time.

He has not personally done simultaneous CI surgery but was willing to

have me be a " guinea pig " for it if I really insisted. One of his

concerns, though, was about my inner ear balance, or vestibular

system. I don't know if you've been tested for that, yet, or will

need to be...I didn't think I had a problem, but when we were

discussing which ear was the " best " to implant first, he realized

that he didn't have data for me on that. So I went right over for the

testing and discovered a 35% balance loss in the right ear. One of

the risks for CI surgery is " vestibular insult " . If both ears suffer

insult during surgery, you will be seriously affected for the rest of

your life in underwater situations (can't find up) and in the dark

(falling down). If only one is " insulted " at a time, you might

decide it's not worth risking the balance problem to have the 2nd ear

implanted.

Another issue, which wasn't fully explained but that I understand

better now, is that some CI candidates go into the process with

unrealistic expectations of the results they hope to have. They are

early discouraged that what they hear upon activation is not the way

sounds are supposed to sound. They don't like how the BTE feels on

their ear and they limit their wearing time, thus limiting their

rehab opportunities. Some of these people don't realize they will

have work to do, i.e. listening exercises and audiobooks, to

rehabilitate their hearing with the CIs, so they give up and " waste "

the opportunity they've been given. So, the surgeon wants to see if

all the bother and expense is worth it in each individual's case.

How are you adapting to the CI and are you having a good result with

one before bothering with the 2nd and it's accompanying risks?

So, I ended up having my right ear (the one with the balance loss)

done first, so that if there was additional " insult " , I'd still have

my left side fully functional. It took me about a week to really

feel good again, and I can't imagine the discomfort of having had two

done at the same time. Maybe I'm a wimp, but one was enough. I

recovered for a month before my activation, and had good results at

my initial mappings. At week 2, my audiologist said she'd conferred

with the surgeon about my case and suggested that since I was doing

so well, why don't I go ahead and get the second ear done? Since I

still had time before the end of the year (deductibles...) we

scheduled it as soon as possible. Also, since my " insurance " is more

like a self-pay situation, they could fast-track me unlike an

insurance patient who has to go through the insurance company

billing. So, I'm in the recovery time for my second surgery,

awaiting activation in December.

I am pleased with the process I've taken and glad to have done them

one at a time. True, I had two recoveries, but they were more

manageable and more controlled than a radical, risky one-shot " fix " .

So, that's my experience, and I'm more than pleased with my results

so far.

I hope you have a personal peace about your process, even though the

trauma and grief of the hearing loss is always there. Do your

research and ask lots of questions, and you'll feel more informed and

confident of your decisions. Wishing you all the best in these

coming weeks. --