What You Should Ask at Your Cochlear Implant Evaluation
The cochlear implant (CI) journey can be both exciting and overwhelming. Advanced Bionics recognizes the importance of this decision, which is why we have asked Pacific Neuroscience Institute (PNI) to help provide answers to common questions to consider during the cochlear implant evaluation process. Take these questions with you to your own CI evaluation appointment to get a better idea of what the CI journey will look like for you!
At PNI, our community-based cochlear implant program is dedicated to patient-centered care, evidence-based practice, education and outreach. We have a comprehensive team to support the needs of each patient from the moment they schedule an evaluation to post-implantation support. We work collaboratively with multidisciplinary teams within PNI including brain health, auditory training (with speech therapists), geneticists, physical therapists, and research.
We hope answering these questions dispels myths and fears regarding the cochlear implant process and helps motivate you to learn more about your hearing health.
Questions to ask when considering getting a cochlear implant
The Process
Q: Do I qualify for a CI on both ears?
A: Adult patients, even with Medicare, can qualify for cochlear implants in both ears.* It depends on each individual ear threshold and performance with a well-fit hearing aid. We look at each ear individually and will recommend a second implant if that ear meets candidacy criteria or if the patient expresses lack of hearing aid benefit.
*Cochlear implants are covered for Medicare beneficiaries who meet the CMS criteria for coverage, and coverage for adult Medicaid recipients varies according to state-specific guidelines.
Q: Can I have both ears implanted at one time?
A: While this is common practice, it can differ based on the clinic or your individual needs. This is a great question to ask the hearing care professionals at your evaluation appointment.
Q: Do I have to make a decision today?
A: Your evaluation day will likely involve a visit with an audiologist or surgeon, or both. These visits are designed to gather information regarding your hearing health and the options available to you. There is no pressure to decide to proceed on the day of the CI evaluation.
Q: If I don’t qualify for a CI now, what are my options?
A: Depending on your hearing levels, we would recommend appropriate technology to improve your hearing and communication skills. We usually recommend monitoring candidacy every 6 months to a year.
Q: How long does it take to receive approval to move forward with a CI surgery?
A: This is a great question to ask at your CI appointment. Timelines for getting a cochlear implant have many variables, including funding (Medicare, PPO and HMO), and availability of your surgeon/surgery center.
Q: Is there a long wait to be placed on the surgery schedule?
A: This will depend on the center working with you. Ask about your individual timeline.
Q: How often will I come back to have adjustments made to my CI?
A: It can take some time for your brain to adjust to hearing with your cochlear implant. The number of adjustments will depend on your individual situation. At our clinic, we have found that it takes 3 visits within the first 3 months to optimize the sound quality. After that period, we see patients annually or as needed. Of course, we see patients more frequently if requested. Also, with AB we utilize their Remote Programming platform which allows patients to get their CI settings adjusted remotely without having to come into the clinic. They find this option very convenient.
Q: Do all my appointments need to be in person?
A: No, we utilize AB’s Remote Programming and the AB ListenFit app for assessments remotely. It is a great way to adjust and monitor progress without needing to travel to the center.
Medical
Q: Will I be able to have an MRI with no restrictions on my head position?
A: With the right cochlear implant, you can have a worry-free MRI. The HiRes Ultra 3D cochlear implants by Advanced Bionics have a specifically designed multi-magnet assembly that allows safe MRI scanning, without angular restrictions of the head, and without surgical removal of the magnet assembly or a bandaging protocol.
Q: Will I lose all of my hearing during the CI surgery?
A: Not necessarily. CI surgeons nowadays are skilled in hearing preservation so that they can allow the patient to keep their natural hearing as much as possible. This results in acoustic and electrical hearing in the same ear if there is enough hearing to be preserved. The risks and benefits of hearing preservation should be discussed directly with your surgeon.
Q: Is there an age limit for cochlear implantation?
A: No! In fact, we have implanted individuals from very young to quite old.
Ease-of-Use
Q: How do I make changes to my volume or programs?
A: Patients have the choice of using the very simple AB Remote App or the buttons on their speech processor.
Q: What if I don’t have a phone or remote, how do I change the volume or program?
A: Your hearing care professional should always activate the processor buttons for you, so you can easily change their programs, volume and answer their phone calls.
Q: Will I be able to use the phone with my implant and how will that work?
A: Yes! You can stream phone calls, music, meetings and other media directly to your implant. The microphones are also designed so that you can speak on the phone hands-free.
Hearing with Two Ears
Q: What are my options for hearing technology on my other ear?
A: AB has an option for every hearing configuration. The options include a second CI, a hearing aid that is compatible with the cochlear implant, or a CROS device that sends the information from the ear with no hearing over to the cochlear implant ear.
Q: Can I control both the CI and hearing aid with a single mobile app?
A: Yes! Patients find it very convenient to have one app that controls both ears.
Q: Can I connect my CI and hearing aid to my flip phone, computer, tablet or other devices through Bluetooth?
A: Yes, with Advanced Bionics you can stream bimodally (cochlear implant and hearing aid) from any Bluetooth device such as a laptop, tablet, TV or phone.
Q: What features do I gain with the different bimodal options for each company?
A: What is unique about AB is that the hearing aid and cochlear implant have the same sound processing. They work together in noisy and difficult listening environments just like a pair of hearing aids do. All added programs are synchronized between ears, and the devices speak to each other to optimize all situations.
Ongoing Support
Q: What resources should I sign up for to actively participate in auditory rehabilitation?
A: Word Success is a fantastic free rehabilitation resources from AB. At PNI, we also offer a free support group and auditory rehab with our speech therapists which can be billed through insurance. Our program’s resources can be done in-person or virtually. At our center we are launching an educational suite to help inform not only our patients, but also their caregivers regarding hearing health and the cochlear implant journey. We are also partnering with AB to provide dedicated in-person support at our center.
Q: Are these free, and for anyone to use?
A: Absolutely. Free tools and support for AB can be found at Advanced DigiCare.
Q: What support is available when I have questions after I'm implanted?
A: AB has a support line and AB Success Team, which can help with troubleshooting your processor, rehab questions, insurance issues and more.
Ask your hearing care professional if there are any local resources or community groups.
The journey to cochlear implants is filled with questions, but it also represents an opportunity for growth and connection. By utilizing this checklist, you can feel empowered to make informed decisions about you or your loved one’s hearing health.
Remember, you’re not alone on this journey, and there’s a community ready to help every step of the way.
Note: The views expressed in this post are those of the author. Each person's situation is unique so your experience may not be the same. Talk to your hearing care provider about whether a cochlear implant is right for you.
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