Reclaiming My Life with Two Cochlear Implants

Fri, 1 Oct 2021 by JinMing Zhang

When I was 21 and in college, I suffered a sports injury. As a part of the treatment, the school doctor gave me gentamicin, a drug that I found out later was ototoxic and can cause permanent hearing loss. At first, I noticed the ringing in my ears. But by the time my hearing was tested, I was diagnosed with bilateral sensorineural hearing loss that sloped down to 70 dB in the higher frequencies. 


When hearing aids are no longer enough

Over the next twenty years, I graduated college and started working. I married and had children, immigrated overseas, invested in real estate and stocks, and studied business management and law. On the outside, I lived the life of a successful, “normal” person. But during all this time, my hearing was continuing to worsen—all the way down to 100 dB. I tried all sorts of hearing aids from Siemens, Starkey, and Phonak, including the Phonak Naída. But it was no use. It was getting harder and harder for me to hear. 

During meetings, when faced with three or four colleagues having a spirited discussion, I could no longer react fast enough to participate. Where I used to be able to participate in important negotiations and business dealing, it now all seemed impossible. As a result, I had limited opportunities to advance my career, despite my many of years of tenure and experience. 

On the outside, I lived the life of a successful, “normal” person. But during all this time, my hearing was continuing to worsen.

My audiologist who fit my hearing aids told me that once hearing loss gets past 90 dB, the best solution is a cochlear implant. So I started doing research into it. I learned that this technology has been in clinical and commercial use since the ‘70s. It’s a mature technology and surgical procedure with minimal risk. Nevertheless, even knowing all this, it still took me a few years to take the leap. Like many people, I procrastinated and thought I could “make do.” I still had fears about undergoing surgery, and I also had concerns about the cost of maintaining a CI post-implantation.

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Choosing AB

In the end, I decided to get implanted because my hearing got so bad I could no longer live and work the way I want to. I chose AB because I felt this American company offered the most support in China. It seemed to me to be most enterprising and also a very popular company. I especially appreciate AB’s partnership with Phonak, whose hearing aids I wore previously. 

Because I’ve worn all sorts of the best hearing aids for more than 20 years, I am deeply aware of how hard it is to recover hearing once it’s lost. So whether it’s hearing aids, or CIs, my expectations of the achievable results were realistic. 

Through my own research and friends’ recommendations, I chose one of China’s most famous CI surgeons for my implantation. I can only describe my surgery as both easy and difficult. Easy because the surgical team was super professional and efficient. I simply had to do what I was told because I trusted their expertise completely. It was also difficult because like for most people, it was my first time undergoing CI surgery. Despite the care and comfort provided by all the hearing care professionals and my loved ones, I was the one who had to take the journey from having my hearing destroyed to restored again. 


On the path to hearing again

A month after the surgery, my implant was finally activated. Everything I heard was high pitched. Men’s voices sounded like women’s, or like children’s voices when they’re trying to sound silly. I couldn’t understand speech initially. 

While I did a lot of aural rehabilitation training on my own, I found that a good listening practice was to chat with familiar people. But still, the greatest improvement came when I worked with an aural rehabilitation specialist. It took me a month of intensive auditory training to recover my ability to understand speech again. But for someone who has struggled with profound hearing loss for so long, this was not a big issue. I’ve documented my progress in the first weeks post-activation below. 

Week 1 I listened to children’s poems on a CD while following along in a book. I had to read along in the book or I wouldn’t understand what was recited on the CD. This way, I gradually progressed to listening to middle school textbooks on CD while following along in the book. 
Week 2 I started practicing listening to the news on my phone app. Because the newscast was delivered there in a slower rate of speech, I was able to understand.
Week 3 Via headphones, I could understand a regular newscast. I also started to be able to understand news and talk shows, even when the pace of the discussion picked up. I could enjoy music again. And after a long, long time, I could hear the voice of a soprano again. 
Week 4 I started to be able to understand English when it was spoken slowly. 
Week 5 In quiet situations, I could understand conversations 100%. I could even gauge the emotions of speakers based on their breathing patterns.
Week 6 It was my first follow-up visit back at the audiologist for finetuning and mapping adjustments. I was still in the process of getting better. I still needed to work on hearing better in the real world with lots of background noise. 

Note that all these good results were achieved in quiet listening environments, or when I was listening through headphones, or if the sound source was close by. If there was background noise, or if I was a bit farther away from the TV or radio, then my speech understanding ability dropped significantly. 
 

Hearing with a CI

I’ve also noticed that sound quality can make a big difference. For example, listening to the TV may not pose much of a problem for those with normal hearing, but at first, it was difficult with a CI. But if I could hear it through a headset or streamed directly into the CI, even if the volume was low, I could hear and understand much better. That illustrated to me how sound quality deteriorates over space and distance, and how detrimental to speech understanding that can be for those with CIs.

I did notice an advantage a CI has over normal hearing ears. With automatic gain control (AGC), the CI sound processor can instantaneously adjust the loudness of the incoming signal so that it is audible but not uncomfortably loud. For example, the sound of firecrackers can cause pain in normal hearing ears, but not for those with CIs.

Overall, I feel like CIs cannot be compared to hearing aids at all. The CI offers an improvement and superiority more dramatic and fundamental than is imaginable with a hearing aid. In the past with hearing aids, every time I walked down the street, it always sounded so noisy and disruptive. But with my CI, everything simply sounded rich and comfortable.

Two months after activation, while I could understand everything in quiet, I was still disappointed that it was difficult to hear well in noisy situations, such as in restaurants, shops, hospitals, or in the car with just one ear. For example, at the dinner table, if the speaker was not sitting on my implanted side, the sound of clanking dishes and cutlery would drown out the speech. I felt that with one implant, these more challenging situations—on the phone, restaurants, meetings, and social settings—my hearing was still less than ideal.

The CI offers an improvement and superiority so dramatic and fundamental it is unimaginable with a hearing aid.

A second CI

I learned that it is precisely those situations that listening with two CIs can really help. The brain requires input from both sides to help pick the speech out of noisy background noise. Those with normal hearing,  rely on hearing with both ears in those situations. For me, I would need two CIs. I was told this can help improve my speech understanding by up by twenty to thirty percent. I was also told that if I was to “go bilateral” (two implants), it was best not to wait more than six months in between the two surgeries in order to avoid any potential neural atrophy on the non-implanted side. This was one of the reasons that I decided on a second implant so quickly after the first. 

In June, I received my second implant from AB, and became a bilateral CI wearer. To train my brain for the new CI, I did similar aural rehab exercises like before, but using the new implant only. I trained my hearing three to four hours every day. 

At first, I wasn’t used to it. But over time, with two implants, my hearing improved significantly, especially in those noisy situations where I used to have so much trouble. With the StereoZoom feature that’s only available when using two AB CIs, I can now focus directly on the speech coming from the person in front of me, while the background noise coming from everywhere else is significantly reduced. This has made everyday social situations like going out with friends, attending gatherings and meetings so much easier for me. Unlike when I had hearing aids and had to either avoid these situations entirely or half-guess, half-bluff my way through conversations, listening with two CIs has made everything so much easier and more natural.
 

The possibilities are endless

With my CIs, my hearing has been returned back to me. With the added Bluetooth connectivity benefits, the possibilities seem endless. With the waterproof options, I can even swim, and clearly hear the splashing water.

To a late-deafened adult like me, undergoing surgery twice and learning to hear again through CIs was a journey and transformation so complete it was a metamorphosis. I went from the abyss of depression and despair to reclaiming my hearing, and thereby my life and my hopes and dreams. I know deciding to pursue a CI, choosing the right CI, and committing to rigorous aural rehab after the activation, were all part of doing right for myself. Improving hearing wasn’t just about changing how I live day to day, it was about changing the course of my entire life.

How the human ear works is one of God’s most intricate and incredible creations. When we lose it, it’s nearly impossible to replicate through technology. But I feel that through their partnership with Phonak, AB’s CI gets pretty close. For those of us with severe and profound hearing loss, a cochlear implant improves the quality of our lives, helps us learn and work better, and ultimately, allows us to enjoy life.

I am now 50 years old. During the morning rush hour, I see everyone on their commute with their headphones and earbuds. With my bilateral implants on my head, I feel pretty cool in the crowd. Perhaps the integration of man and machine is a future that will arrive even sooner than we expect.

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