My Initial Stim Experience

Happy Easter! I'm finally back to Dallas from a busy Easter with family and friends in St. Louis. I got to visit with several friends I hadn't seen in a long time, find time to continue my tradition of helping Grandma and Grandpa Padgett prepare for their annual Easter Brunch and Easter Egg Hunt, spend time with Brian's wonderful family and then spend Easter Sunday visiting with my Padgett family which is always fun but chaotic! Grandma Padgett said she counted 95 people this year! I probably overdid myself but what's new? In addition, everyone had to know how I was doing with my cochlear implant. Usually on Easter, I help sit people and serve drinks and food to people all morning but today, I decided to stay out of the kitchen because it was very loud and not the place to catch up with everyone. I was ready for a long nap by the time we left at noon!

I want to back up and tell you what happened last Wednesday when I went for my "initial stimulation," "activation," "hook-up," or whatever else one might say about getting a cochlear implant turned on for the first time. I was very nervous because even though I'm almost a full-fledged audiologist and have a lot of knowledge and experience with cochlear implants and counseling children and adults about expectations with cochlear implants, I did not know how I would first react or "hear" with my cochlear implant. So many variables play a role in how a person will do with a cochlear implant and how quickly they will learn to make sense of sound.

Anyhow, my mom and dad, as well as my friend Michelle, who is a cochlear implant audiologist at UT-Dallas/Callier Center, came with me to my appointment. First, I had my check up with Dr. Roland who did my surgery. He said my incision looked good and I was ready for my initial stim. Along my incision there is surgical glue on top of the stitches which will eventually dissolve and come out. I didn't know this but it takes about 4-6 weeks for the glue to come off and about 8-12 weeks for the stitches to go away. Good thing they're not visible since they're behind my ear! He also said I was free to do whatever I want including scuba-diving, and sky-diving (not that I plan to do those things anytime soon...). However, I'm looking forward to getting back to running, working out, traveling for my upcoming trips, and, oh, looking for a job...

My parents also asked many questions. I was very disappointed that my dad didn't ask the one question he really wanted to know, which was "Does Dr. Roland know the song 'Roland the Headless Thompson Gunner' by Warren Zevon?"...He also sang Werewolves of London...don't worry, I didn't know who that was or what these songs were either.

I then had my appointment with Pam, the audiologist. This was the first time I had met with her since I had my pre-evaluations with another audiologist who has since moved from Dallas. However, I had heard many great things about Pam so I was happy that she would be doing my initial stim. When I got to her room, she had my new sound processor hooked up to the computer ready to get started. The room wasn't very big but we managed to all fit and my dad happily videotaped everything.

The first thing that Pam did was have me put the processor on my ear and make sure the magnet was strong enough to stay on my head where the internal magnet of the implant was located. Then she measured impedances and made sure all the electrodes inside the cochlea were working. The lower the impedances, the better the electrical current is able to stimulate the cochlea. The impedances looked good and so then she moved to the next step. She ask me to tell her when I first hear two beeps. She wanted to find the softest level (t-level) that I could hear for each channel or electrode region it stimulates along the basilar membrane of the cochlea. When she presented each sound, I felt the vibration rather than heard it. After doing this for 22 channels, she measured my C-levels for each channel which is where the sound is "loud, but comfortable." Again, for me, this was hard because I was feeling the stimulus instead of hearing it. Each presentation was like a pounding sensation rolling through my head. I'm not sure if this is normal. After this step, she went live. She turned down the levels slightly and then turned on the processor. I was very nervous because I didn't know what to expect and knew it was not going to sound good especially since I was feeling the sounds more than hearing them. So when it went live, it was VERY overwhelming. I starting tearing because it was new and uncomfortable, somewhat like a really big headache. Pam turned down the levels to where it was comfortable and then I listened to hear talk about setting different programs and the different accessories and pieces I would be taking home in my big white briefcase, which is really heavy! It was hard to pay attention with all these sound stimulating my auditory nerve and vibrating through my head. I kept thinking, 'I hope this gets better and I start to hear the sounds because feeling the sounds is not comfortable.' The processor has room for 4 different listening programs. After discussing how to utilize the 4 programs, she decided to give me a program that I was currently listening to, then another program that was slightly softer, and then a 'noise' program, and a 'focus' program to try. These two programs are designed to allow a CI user to understand speech better in noisy situations.

The entire appointment took about 1 1/2 hours. I return on April 12th to readjust my levels. I left the appointment with a very big headache and a lot of confusion about whether I was hearing or feeling the sounds. I can't remember if I explained my hearing loss yet or not, but I have just a mild hearing loss from 250 Hz to 1500 Hz (low to mid frequencies) and a severe/profound loss from 2000 Hz to 8000 Hz (mid to high frequencies) in my left (good) ear. My right ear that has been implanted has been profound and unaidable since I had meningitis at the age of 7 months. I have not heard in this ear in 25 years, but I have already heard many sounds with my left ear. Explaining what sounds through my cochlear implant are like is hard because I cannot compare it to natural acoustical hearing. However, after 5 days, I can say that the vibrating feeling of sounds are becoming much more bearable and I am hearing soft buzzing noises when louder sounds are present. Another interesting thing that happened on the first day was that I noticed that as I got near my TV or walk by certain places in the hallways at Callier Center, I was hearing a loud buzzing sound. This sound I knew because I wear a hearing aid on my other ear. My hearing aid has a technology called a telecoil. This telecoil picks up electromagnetic energy and is very useful for allowing hearing aid users to utilizes the telephone while cutting out the background noise. I recognized this right away and turned off the "autophone" feature that the Nucleus 5 device has as a default setting. I was able to do this with my fancy little "remote assistant." It's a really great remote control! Now, I thankfully don't have to hear buzzing sound anymore. I have to remember to tell Pam about this because I wouldn't want patients who aren't audiologists to have to listen to this sound and not know what it is! The good thing is that I definitely knew I was hearing that electromagnetic energy, which means I will be "hearing" other sounds soon, right? :)

Alright this is PLENTY long for today. I have lots to show and tell though so I will be writing again soon. Now that I have 24/7 access to a computer for a week, look forward to more updates! I have pictures too...