Balance changes after implantation?

Cochlear Implants
#1

I’m wondering what others experience with their balance has been after implantation.

I’m about 20 months post implant and have had two serious cycling accidents in that time, after cycling serious accident free for 30 years. As I’m sitting here nursing my broken ribs and thinking about what has changed, my implant came to mind - of note I don’t wear it while riding because it doesn’t fit under my (now destroyed) helmet. I wear it all the time otherwise. I don’t notice anything myself but it’s not something I was thinking about either.

When I did my balance test before the implant, they told me I had no inner ear balance. They said that was fine though and that we just learn to cope without it (they did multiple tests to confirm using an older and new system, while pouring water in my ears). I haven’t re-tested since, but also haven’t had issues like vertigo.

So I’m wondering what others have found, if they noticed any changes after they got the cochlear implant? It could just be coincidence and bad luck. I’ll heal, but it has me wondering if something changed. I’ll follow up with audiology too next week.

#2

If you think you’re at fault on the accidents, a question comes to mind, was it a balance problem or situational awareness problem. If you can’t hear traffic, that is a different problem than going off the road because you can’t balance.

WH

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#3

Fair question. In the latest accident I either didn’t see or became unbalanced while going over a speed bump at a normal speed and went over the handlebars. These type of accidents happen so quickly that your brain doesn’t have a chance to react except on instinct and that’s where I’m wondering if 30 years of muscle memory for my balance has possibly changed with the implant.

It could be nothing, it’s just something I’m pondering while sitting on the couch recovering. The CT scan showed nothing of concern luckily. I was wearing a brand new MIPS helmet, which did it’s job.

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#4

I hope you figure it out so you may continue to enjoy cycling. As a motorcyclist, I would be sad if I couldn’t do it any longer.

WH

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#5

@Syncros

This might not be the case with you but I’m friends with twins who both have AB CIs. They can’t ride a bike when only hearing from one ear. They get dizzy, altho they’ve never greatly explained why.

I only know but we were meant to go on a bike ride last summer and one of the twins magnet site was red so she said she wasn’t able to go on a bike ride as she’ll be too dizzy with only one CI.

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#6

Really tough to sort out. I know reaction time increases as we age. I’d likely discuss with a physician.

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#7

I am go to say something I have noticed. My balance is off if I walk around without my aids or with my aids muted compared to walking around with my aids on at the normal volume settings. I ride a Vespa GTS 300 scooter, and use a half shell helmet. Lately I have been riding without muting my aids and I feel more in touch with my surroundings.
This last Thursday I went for a ride and muted my aids, as an old habit and was definitely out of sorts, and ended up laying my scooter down on the side of the road luckily in high grass and fallen leaves. No injuries to me or damage to my scooter but it was a wake up call.i spend a whole day troubleshooting what I did wrong or what I noticed different with the s scooter or road conditions. My conclusion was that it was me not hearing as I should. I rode the same route today with my aids at normal volume levels and didn’t have any issues. Could it have been something else I guess so but I can but a finger on it.

Do yourself a favor and find a helmet shop with someone that can work with you and find a helmet and make changes in it so you can use your processor/s

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#8

Yes, I had balance issues after having my CI, more specifically after activation. It was only spasmodic episodes though. I was walking along then I would start wobbling along, just for a minute then everything went normal again. On my 2nd mapping I was sitting on a chair,my AuD increased the stimulation of the 1st electrode, I had to grab onto the desk to prevent myself from falling off the chair. As a result of nearly falling off the chair my 1st electrode is turned completely off. The 2nd electrode has been fixed at a set level not to be adjusted any further.

I spoke to my surgeon about this, he said it can happen. Especially as electrodes 1 & 2 in the cochlea are very close to the vestibular in the brain. The vestibular is your balance centre. You can ask your AuD to check your electrodes. Or you might benefit from doing the vestibular physiotherapy course. Good luck.

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#9

I’ve ridden motorcycle (think LOUD) with ear plugs in almost all the time for many years. Maybe it is just that I’ve always done it that way? My VA audiologist had a custom plug set made for me. My first bike was a used bike with straight pipes. No muffler or other dampers. My current bikes have stock exhausts bike with the wind blowing over the helmet and all it it still around 100 dBA. Sometimes I ride with others with noisy bikes that are much louder. Some wear no protection and I don’t understand how they stand it.

But no balance issues here with plugs as quiet as I can get them.

WH

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#10

Like I said it was the only change in a while. With the Vespa the loudest noise is the wind noise. And like I have said before my aids kills wind noise like crazy. I can drive with all winds down in the Jeep now. The helmet lessens the wind noise too.
I have never liked loud exhaust, and dislike even coming up on someone with loud exhaust even in my Jeep with all the windows up. I also have never liked loud music, it makes me nervous as does loud exhaust.

#11

I’ve looked a bit extensively into the balance side of things and the possible complications that getting a CI may present on a personal basis.

Just a little background, I was deafened as a result of meningitis 41 years ago - completely in the left ear and severe-profoundly in the right. That also affected my balance - I was told of how I was once walking around, and after recovery I was back to crawling.

In the lead up to surgery, my surgeon informed me that I was at risk of chronic disequilibrium if I only had vestibular function in the ear that was going to be implanted, going by the possibility that all function had shut down in the other as a result of meningitis. Didn’t sit well with me, so had some testing done to see what my safety & risk was. Turned out that I did have vestibular function in both ears, though only a very tiny amount. It’s pretty evident that’s the case if I were to try balancing with one foot directly in the other and then closing my eyes to remove the visual component of balance and rely on the proprioceptive and vestibular systems - I would immediately start to sway and fall over.

I’ve not noticed any changes to balance post-surgery. I do a bit of bouldering (indoor rock climbing without ropes) and am fond of the problems that require fine balance. I have not found it to be any more difficult than before - falling off in the same places the more able bodied do.

The surgeon did remark that even if the surgery did affect the vestibular system in the implanted side - a bit less of next-to-nothing is still next-to-nothing. So for you, it wouldn’t seem likely it would have had any effect given the lack of vestibular function in the first place.

Barring bad luck or coincidence, how’s your vision and proprioceptive function? Since that’s the only two things that are being used to keep equilibrium.

#12

I learnt this today :slight_smile:

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image1668×2138 389 KB

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#13

So… The question I have is when did you loose your balance/hearing? Something qualified you for your CI, was this a slow decline of hearing/balance or sudden? Its possible that you had balance, and lost it along with your hearing at the same time. If this is the case then you are adjusting to a CI and a new way to balance. I know this is the case for me. Balance is much harder to cope with (for me). I will never go near a motorcycle again, but yes I can ride a bike fairly easily. It is very clear to me that I am using my vision significantly to compensate for loss of vestibular systems.
My guess is that like your hearing, you also lost your balance, but it is harder to notice (especially if this happened slowly over time). This means that the things you used to be able to do my not be wise to do going forward. Imagine loosing an arm and trying to go shooting. You will be able to do it, but it will be a very different experience.
Hope this helps,
Dave

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#14

on the Sociological side of the street - people have been behaving differently during the pandemic stress. you don’t mention if other people were involved in the first event, tho evidently the second was a solo event. there are more Angry/Upset behaviors happening during Plague & War & Recession environment.

#15

I was thinking about this… If you have no vestibular response, then how could the CI be impacting your balance? Without a working vestibular system you will use your vision and sense of touch to balance. The CI would have no impact on these systems. Only people with vestibular function could be impacted by a functional CI, and this is rare.
My guess is that while you are fully compensated to loss of vestibular function, you are still not fully aware of its implications. This includes “blind spots” where you do not get feedback from visual or touch and are blind to movement/orientation changes. Riding a bike exasperates these vulnerabilities.

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#16

I appreciate all the responses, they’ve given me lots to mull over and think about while I’ve been healing (i’m doing much better now).

In speaking with my audiologist, they dont think it was directly related to the implant - it could have just been a freak accident, but there is also the factor that when you’re used to hearing on both sides, when you take one off and rely on just one ear, you become slightly unsettled already. Before I get back on a bicycle, i’ll be finding a helmet that allows me to wear the M90 CI i’m about to get while riding. I dont think i’d feel comfortable riding without it, even if it had no effect in the end, being able to hear everything around me better is always going to be a net benefit.

#17

Try not to get in a big hurry. You have taken an adventure that takes a little time to adjust to.
Things will fall into place.
I understand how you want results and answers right now, try to be patient.

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#18

For what it’s worth, I have SSHL & a Nucleus 7 processor that I wear under a standard bike helmet. Hearing in my other ear is normal. The surgeon knew wearing a bike helmet was important for me so placed the magnet in a position to allow this. However, although situational awareness is better than without the CI, it’s still not very good. It takes me several seconds to sometimes be able to work out which direction a sound is coming from. I have to turn my head, think “my natural left ear is hearing directly from my left but my right CI ear is hearing directly from my front”, then try to assimilate that information into a sound source direction. Today, I was driving & a fire engine started blaring somewhere… I had no idea which direction it was coming from based on sound alone.

Back to the original topic, post-implant I’m still mountain biking, still ride off-road electric unicycling & have learned how to manual unicycle! However, I can’t lie under a desk to tidy cables, then stand up; this (and only this action) gives me vertigo.

#19

Can you find birds in your front yard?
They have been a great trainer for me to learn directionality.

#20

What if you sit up first, let your head settle the stand up. Does the vertigo still happen then?
Have you seen a ventricular physiotherapist to help with this?
I have general balance issues, which I put down to old age, decline in physical strength and my CI.