CI Rehabilitation after Activation

I’ve been trying for over 3 years now why I lost my residual at 15 months PO. No one is able to explain why! It’s just one of those things.

This numbness will resolve itself over the next 10-12 months. It happens because of all the superficial nerves from around the back of the ear where your surgeon cut to get into you inner ear.

All those other sounds you’re hearing could well be tinnitus.

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This is a good sign that you are learning the CI.
My guess is your audiologist will push the volume over the next 6-12 months. Things will be loud and annoying during this time. You will want to turn volumes down.

At 1.5 years to 2 years things will really start to normalize. All the loud things that bothered you for so long will begin to fade and hearing will improve in noisy environments. During this time you will also get localization back with practice.

Yes, lots to look forward to.

Do you plan to go bilateral?

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Actually, I want to understand why a procedure that was completed without any interscalar deviation, used a new robotic devise for very slow careful insertion and with an array with more than adequate head space to the apix, would still result in loss of natural hearing. I also assume that the doctor, CI companies and robotic developer would want to understand this also. Unless and until there are major improvements in outcome, CI will continue to be a rarely used prosthetic.

Lens implants and even Lasik eye surgery have become almost as routine and widely used as dental crowns or fillings. Why? Because they result in almost perfect improvement, with close to 0 side effects and are affordable by most people. This was not always the case.

My options were limited and I had accepted that this was my only option to be able to hear at even an adequate if not perfect level. I just hope that my experience and those of others are thoroughly documented and can serve to advance the technology to be like cell phones - exponentially better and lower in cost over just a few decades.

I know that I have a lot of work ahead of he and I intend to commit fully to it to gain the maximum benefit I can. This is a new adventure and I am all in and not afraid to ask questions to help along the way.

Actually they set 4 programs up. Upon asking how they differed, I was told that they were increases in volumes. The first was the threshold for barely hearing. I was at that level for about a week, but felt it was just too low and have moved it up to level 3 and turned down the volume on the controller that comes with the system (FineTune Echo or the one on the phone).

This is much better. Even without a HA in my other ear, I am able to understand speech in a quiet setting quite well. However it is accompanied by a raspy almost parallel version of the speech that I am trying to understand the source of. Almost like an echo. A topic for my audi.

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I believe this is an easy fix for your audiologist.

As far as you losing your residual hearing there might still be a chance of getting some of it back as your ear heals and swelling goes down. Small chance probably. I have read this before, no experience with this at all. The other thought is everyone I have read about that did keep some residual hearing lost it in time.

I was told by my surgeon to expect 30% loss of my residual hearing that I did have going into the surgery. That did not leave much from so little hearing I had. I expected to be dead after the surgery.

Being bilateral I am deaf when the processors are off except for the crazy tinnitus. Thankfully that goes away when the processors are on. Being totally deaf was an eye opener at first but quickly subsided. Thankfully I have a helpful wife who understands all this.

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Lasik and cochlear implantation seem really different to me. Lasik uses a laser into a surface structure with great visibility. The cochlea is tiny (fat pea-sized) and you can’t see into it, and you have to maneuver around some important facial nerves that you do not want to damage to get good access to the round window, which impacts your angle of approach. And then rather than a laser, you’re shoving a relatively large object into it. Even microtrauma may result in leaking of the perilymph, which is ototoxic, mixing of the perilymph and the endolymph, which is ototoxic, direct damage to the organ of corti, minor damage resulting in scaring that may lead to ossification down the road which also damages hearing. On top of that, a lot of things that result in congenital hearing loss also cause minor or significant abnormal formation of the cochlea, leading to anatomical differences that will complicate the surgery.

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My point was not to equate the procedures but to shed light on the pace of development. Lazik (RK back in 1970) was a procedure discovered by accident when a patient in Russia suffered damage to their cornea from broken glass. After treatment and recovery, they discovered his vision actually improved. The surgeon developed the initial procedure that involved making incisions around the cornea to change the focal length. There were serious complications that were highly dependent on the skill of the surgeon. It was eventually replaced by lazers and have gotten much better and safer.

CI has been around for almost the same length of time and while there have been improvement (channels, processors, software), it is still far behind the advances made for lens implants and Lazik. I accept that it is hard, but I dont see enough effort by companies to make it MUCH better.

Maybe part of the problem is that CI is performed at hospitals and there is little incentive for them to improve. It is covered by insurance and that’s the driver. Lens implants are performed in clinics that are often privately owned and use other outpatient facilities for the actual surgery. They are focused on making a profitable growing business, so improvements come naturally to them.

My experience with my CI was that the hospital had their own ways of doing things even to the exclusion of some of the advances in technology that were available to them from the CI companies. Most fought for years using the RW for entry. Data on successful trends has been very hard to find in published journals. Ditto complication trends.

It is still highly dependent on the skill of the surgeon operating by feel or in the blind. Practices change slowly.

I think cochlear implants have made huge progress in the last 50 years. Apart from what @Neville said above, you’re talking about stimulating something with tens of thousands of nerve endings being stimulated with an electrical cable and zappers. We just can’t make something with that many endings in such a small space (yet) so there’s no way we’ll get the resolution necessary to replicate normal sounds.

Your examples above would be more fair if you used retina replacement instead of lens replacement, and taste bud replacement instead of dental crowns.

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Live person for 45 minutes per day for about 6 months. Reading words from prescribed word lists while I tried to work out what they were.

Later, moved on to playing notes on a piano.

And then streaming some of those apps listed above but I never found them helpful. Listening to podcasts streamed to the cochlear was much more helpful. But not as good as a live person.

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I really don’t know a lot about retinal implants, but I agree that it is a better comparison. That said, it doesn’t look like progress has been as good as with CIs according to wiki:

For some reason the idea of retinal implants gives me the willies far more than a CI.

Had a co-worker who was active duty Air Force and was medically retired for it. He was a consultant to the USAF when I worked with him. Man, I sure wish there was something effective they could do for him. He planned on becoming a school teacher.

WH

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I always just think of that scene in First Contact where Picard’s eye gets stabbed by the borg.

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I’m liking Neville’s comparison of CI to retinal implant, altho CIs have been around a lot longer. Part of the issue is that both retinal and Cochlear implants involve surgery that’s literally on top of primary sensory nerve bundle. LASIK, while certainly intricate and done on very delicate tissue, is done on a body part that in itself is mostly inert, the cornea/lens of an eye. There are no nerves and no blood vessels.
A retina or a cochlea is almost entirely made of tissue that’s packed with a variety of specialized cells and their specific and specialized nerve endings.not sure about retinas, but I’ve read papers that imply researchers have “tied” specific hair cells to particular brain areas. That’s more intricate than I can wrap my head around.

The other thing that makes me pause about CIs is implantation involves a skilled person (or their robotic equipment) and very sophisticated, miniaturized hardware. No such hardware is involved with LASIK.

All that said, I do wish “they” were progressing faster and further than they seem to be. Maybe the market just isn’t big enough to get the $$. Maybe the trends like this forum toward more consumer inclusion will help.

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Well. . . but also. . . what if instead of putting money into progressing CI technology we put money into progressing gene therapy and just make the cochlea regenerate.

I think the latter is, unfortunately, much further off. But it is certainly more desireable. So we split our priorities.

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Nightmare worthy. Ugh.

WH

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Especially for those of us contemplating eye surgery later in the year. Thanks @Neville!

Cataracts? Truly a piece of cake. Results are amazing too.

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My mom: Why did I wait so long. It was so easy.

I think she thought it would be long and painful. She was kicking herself for putting it off.

WH

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You’re off to be assimilated! I hope it goes well. :grin:

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