Guest Blogger: Part 3

I'm starting the new year off with a guest blogger...mostly because I have been busy galavanting around between Hastings and Omaha and I just never seem to have the time to sit down and write. I'm hoping to get a post or two (of my own) out this week though!

Here's the third installment of Papa Jim's story about his cochlear implant. We are seeing progress! I don't see him as often as I'd like, but I definitely saw a difference when I was home for Christmas, so maybe it's better that I'm far away....?! Anyway, enough from me...

As the Ears Go By: A Mild Reception

By Jim Sharrick 

Well, come Christmas, I’ll have had my cochlear implant activated a full six months Right off the bat, I’ll answer the question asked most, “No, I don’t understand speech through my implant alone yet”. I’m in no way bummed and pretty much anticipated this result at this time. Testing with the audiologist has shown a marked improvement in speech understanding in environments with competing sounds. Deb, my wife has verified this, so it is therefore accurate. I hadn’t noticed. Since it has been brought to my attention I can tell the difference. The speech pathologist tests show I can differentiate sorta’- kinda’ accurately. I differentiate which sentence she is reading when shown the sentence in writing. The staff seems to be okay with my progress, so I’m good with the “Jim’s doing alright” narrative. That’s nice, boring, but nice. Let’s talk about the unexpected results, because they are much more interesting. 

First of all, there is no sense of distance to the source of a sound. The most reliably accurate sound I get is percussion from the radio. Bass drum, tom-toms, tambourines, high-hat cymbals, etc. it’s all there, and right on tempo. I don’t even use the speaker on the driver’s side of the car, and yet the left ear picks up every beat as if I were wearing headphones, even though the speaker is on the passenger door across the way. The sound seems to originate right in the brain. One of the first experiments I tried was to stand next to the road to see if I could detect on-coming traffic. It’s like the old WWII movies said, I won’t hear the car that gets me. This could change over time. 

Secondly, and it’s hard to explain, it feels like half my brain is activated by wearing the processor. I don’t know if it’s just the activity of having the auditory nerve stimulated, but it’s pretty dead upstairs when I’m not wearing the processor. (For those of you who know me, insert your joke here.) 

Next, the ringing in the implanted ear has dropped in pitch. It’s gone from the old style TV tube whistle to more of noise-induced ringing, say like from loud music or industrial machinery. It’s not important, just different. 

The most important thing I’ve learned, and changed, is my listening strategy. As my hearing declined, all my efforts went toward enhancing speech sounds, and dampening competing sounds. I was discussing (whining) with the audiologist that I could hear keyboarding. She semi-exasperatedly exclaimed that she could, too! It hit me at that moment that now I have to be open to all sounds in order to allow my brain to sort and prioritize inputs, just the same as you standardly-hearing folk do. That’s the opposite of what I’ve done the last quarter-century. 

Finally, the information everyone asks, “Are you being tracked electronically via the implant?” I can’t say for certain. I do know this, at every mall, at every truck stop, and every tourist attraction, I wind up seeing a map that says “YOU ARE HERE”. Coincidence? I think not. Trust no one.

Guest Blogger: Part 2

Our VIP guest blogger, Jim, has finally graced us with a follow up to his first blog about his journey towards getting a cochlear implant last month. It's been quite the journey, but I'll let Papa Jim tell you all about it.

As the Ears Go By: Plugged In, But Not Clued In--The second in a series on one man's experience in getting a cochlear implant

Well folks, it’s clear I have issues with written assignment deadlines. You needn’t take my word for it, since I have dozens of educators who will vouch for me. But enough groveling, because I have big news to announce. I have an installed cochlear implant! I had the surgery to install the implant at Boys Town National Research Hospital in Omaha, NE, June 16th. 

I had to report to the hospital at 8:20 a.m. that morning, so my wife, Deb, and I left Hastings, NE at 5:30 a.m. Ugh. Deb drove, and I snoozed, and my daughter, Jenny, who lives in Omaha, met us there. Once checked in, it was straight to my…umm…guest room, I guess, for a quick change into the traditional backless gown. I was then given a valium, attached to an IV, followed by a injected dosage of muscle relaxant. I crawled onto the little patient cart, and was gently pushed into several stationary objects on the way to an elevator. Once in the elevator, I passed out, and awoke in my room again. I think this is the first time I wasn’t conscious going into the operating room. That staff knows its muscle relaxants. It felt like it only took five minutes for a scheduled two and a half-hour procedure that wound up taking four hours. 

The major negative concerns going into this procedure were the remote possibility of developing meningitis, possible damage to the vestibular system, and possible facial nerve damage. Well, I had two boosters to prevent the meningitis, eight weeks apart, and I don’t have it now, so that worked. My first attempt to stand was surprisingly successful, so no damage to the balance system. The facial nerve issue was a bit more complex than I realized, as the cochlear sclerosis creates what was described to me as a “soft bone tissue growth”. In essence, it can enable the electronic impulses from the implant to go beyond the intended path, and activate the facial nerve. Or maybe deactivate it, because the left side of my face could have gone numb. Anyway, long story short, they tested the connection while I was under, and I was good to go, and knew it when I awoke. 

That same test also checks objectively that the auditory nerve was responding. Since it hadn’t been stimulated in a couple of years, it was a concern in my mind. It’s amazing what all I got done while unconscious. Recovery was the usual routine: take a short walk, then come back for a robe, walk again, eat jello, wash it down with chicken broth, and repeatedly make the same statements and ask the same questions over and over again as if it were the first time. Anesthesia is a wonderful thing. The procedure was outpatient, so I got dressed, and Deb and I made the trip home Monday evening. 

My head was wrapped in a Velcro strap that held the bandages, and presumably, my ear in place. That, combined with the standard post-surgical bed-head, was the look I sported for the next three days. Tuesday was no big deal, as I stayed home. Invasive as having my scalp rolled back, then having a hole bored in part of my skull, and another hole drilled into my inner ear sounds, this was as mild a surgery as I’ve ever experienced; so I put in a half-day at work Wednesday. A more critical look in the mirror convinced me to buy a shower cap for Thursday’s venture, (to cover my ear in the shower, not to wear to work), and the Velcro wrap came off. I also removed the left temple from my glasses to avoid hitting anything vital around my ear. 

Let’s move forward to June 25th, and I made the drive to Omaha again, hair mostly shampooed, this time for a reasonable 1:30 p.m. appointment for an x-ray, then a post-surgical inspection and bandage removal with the surgeon, followed by an appointment with the audiologist, whom I shall call “Jenny”, mostly because that’s her name. Jenny showed me the contents a briefcase-sized case, filled with what she said was $8000 worth of sound processors, rechargeable batteries, ear hooks, cables, coils, magnets, remote controls, and a coupon for some free “Skin-Its” just in case I want to cherry up my units. That’s right, plural. You get an extra everything, just in case repairs are needed to the primary unit. 

Anyway, the big moment had arrived. I got activated. And suddenly, I could hear…more varieties of tinnitus. That’s right, ringing in the ears, only with accurate pitches. I could whistle a scale, and I heard it pitch for pitch, but about three octaves higher. Any sound I heard that could be visually verified I checked, and I was receiving the signal in real time, no delay of any kind. The only sound I found that is virtually the same electronically as it is acoustically is cricket chirping. Now I understand why someone with developed language skills has visits with speech pathologists in his future. I’m getting sound, but none of it means anything to me. The really hard work is still in front of me.

VIP Guest Blogger

Today I have a guest blogger (Woo hoo! I seem so important...I've hit the blogging big time). Don't get too excited though until I tell you who it is, because it might end up being a disappointment.

On Friday we learned about the auditory system and hearing from a neurological point of view. While it's interesting, I really could have skipped listening to that lecture because my entire life has been lectures about hearing and hearing health. Truthfully, I hate loud noises--especially loud music or TVs--and I'm quite confident that my dad is to blame. (DANG IT DAD!...Actually in this case, you killed it on the parenting front...my impeccable hearing and I thank you for being militant about protecting my ears). 

In about a month and a half my dad is getting a cochlear implant on his left ear. In about a month and a half I'll have a father that can hear again (fingers crossed!). For the first time in my life. 

There have been challenges growing up with a Dad who has profound hearing loss, but sometimes it also is entertaining...ask him the lyrics to any song if you're in need of a good laugh--the things he comes up with are hysterical! But as frustrating as it can be for my mom and me, I know that it's so much worse for him. 

We're all part of this service organization called Sertoma whose mission is to "improve the quality of life today for those at risk or impacted by hearing loss through education and support. This is actually the organization that Papa Jim got his Lifetime Service Award from a few weeks back. Well anyway, they asked him to write a blog about his experiences leading up to the implant and about the process. Below is his first installation. He's great (don't tell him...it'll go to his head) and I'm so proud and excited for him! 

As the Ears Go By: One Man's Search for Better Reception

My name is Jim Sharrick, and I am very hard of hearing. A year ago, I came to the conclusion that I would get a cochlear implant. It was not a sudden decision, and not my first step in dealing with my hearing loss. Mine is not a unique story, but one that I hope will be of interest to those facing, or the family of those facing similar decisions.  Like any journey in life, it helps to know where it began. So I will start with the story of my journey to this point. Then I will share my experiences leading up to, and hopefully, following a successful installation.

The condition that causes my problem is called otosclerosis, along with a dose of cochlear sclerosis. I’ve been told it’s hereditary, and the technical explanation is very boring. Essentially, the bones in my middle ear don’t vibrate as they should to activate the cochlea. Still with me? The curious and/or OCD amongst you can Google it. Anyway, both ears are affected, the left one much more so than the right. Both are affected so much, that apart from holding up my glasses, the left ear is useless.

I should point out that my hearing loss occurred after I fully acquired language skills, and that it was a sorta’, kinda’ gradual loss. This is a hugely important distinction, and why I don’t describe myself as “deaf” despite being non-functional socially without the hearing aid in my “good” ear. Being “deaf” typically means a person was born without hearing, or lost hearing at an early age, which makes language acquisition unbelievably difficult to this outside observer. I remember reading as a child, the word “horizon” as “hoar-ih-zon”, despite hearing it spoken as “hoar-eye-zen”. How anyone without hearing learns to read is beyond my understanding. I know it happens, all the time, but the effort must be daunting. My diction is standard, so you won’t hear what I call the “deaf accent” in my speech.

Since you are joining my story in the middle, maybe it would be best to do as if you were viewing a popular series such as “Downton Abbey”. You’ll understand better if I quickly just review the first thirty-five seasons. There I was, a towering 5’7”, 125 lbs, Ghandi-esque in physique, (only without all the muscle), 21-year-old. I was at a buddy’s house, and watching a magical new television service called HBO, provided by something called “cable”. We were watching a movie, and I apparently had the remote.

Some buddy this guy turns out to be, since he started crabbing about the volume level I set. After a few other public misunderstandings, including one really good one that involved my future wife, I had my hearing checked. Sure enough, the local ENT diagnosed the condition dead on, and put me on some nasty liquid fluoride supplement, with a calcium supplement as well to counter-act leaching from my bones. This didn’t last very long, as it tasted awful and ruined the end of every meal. I also didn’t think risking the integrity of my skeleton for what was then a relatively small problem was worth it. The same ENT sent me to a specialist in Denver, just a six-hour jaunt one-way, to see about corrective surgery. The doctor in Denver said I had too much hearing to gamble on the surgery, so the folks and I drove back the same day. All I really remember was that it was the furthest I had ever driven for a sandwich. It was a good sandwich, but not really worth the effort.

Anyway, after a few years passed, the condition worsened, so much that I would get angry if someone tried to talk to me while I was eating. The sound of my own chewing, (yes, my mouth was closed), was louder than the voice addressing me. I’m a really slow eater in the first place, and stopping to listen was starving me. So I was off to another specialist in Lincoln, (only a three-hour round trip this time) who recommended a surgery called a stapedectomy for my, I think, left ear. It involves removing the stapes in the middle ear, and replacing it with a metal prosthesis. After a few days, my hearing improved, and I lectured others like a reformed smoker, shushing anyone who was too loud. That’s the good news; the bad news was that it only lasted for about four weeks. The graft didn’t hold, probably due to a malformation of the bone to which the prosthesis was attached.

For the first time, a hearing aid was recommended, and I got one. Over the next decade, I had the right ear done, same result, got another hearing aid; left ear again; right ear again; and was told not to have any more surgeries. Oh, and was further informed, by the way, you also have deterioration in your cochlea. After that time, I upgraded from the full shell in-the-ear units to a smaller in-the-canal unit for my left ear. Ironically, it was my “good” ear at the time, and the one I used for the phone.

The final surgical attempt was in 2002, left ear for the third time, with again, the same results. I could participate in conversation in a machine shop without any hearing aids. Awesome, you bet! But that damned incus, (another ear bone, trust me), didn’t hold up its end, and that prosthesis dropped as well. Adding injury to insult, about a year later I started to notice that higher frequencies switched totally to the right ear. So much for the left side being the phone ear.

So I got even bigger hearing aids, behind-the-ear units, which worked pretty well for a while. The best part of the bigger units is that you can get about two and a half to three weeks of battery life, since they have room for much bigger batteries. I still noticed some fading, but really had nothing more to try. I already watched TV about a footstool away from the screen to keep the volume as low as possible, sat in booths in restaurants rather than tables to increase sound dampening, and religiously protected my hearing while mowing, vacuuming, (yeah, I do my share), and snow-blowing. I was down to tactics, not remedies, to keep up with the rest of the planet.

Fate and stupidity would intervene to set my path a couple of years ago. I have to remove my hearing aids to get my hair cut. The gal that cuts my hair knows about my hearing loss, and is perfectly comfortable conversing for the two of us, so this is a nice arrangement. It was winter then, so I shoved my hearing aids in each of my coat pockets. After the session was done, I got into the car, and while the car door was open, pulled out my gloves. The next day, I found the perfectly flat hearing aid for my left ear, right where I had driven over it. I felt fortunate to not be wearing it at the time of the incident.

So I got new units, a bigger, (how is that possible?), more powerful version for the steadily declining left ear, and a smaller unit for the right ear. Normally, I’d get the same size, but the bigger unit didn’t have the ultra-cool receiver for my new TV transmitter that plugs into the headphone jack. Did you know there is dialogue during chase scenes and very loud musical backgrounds? Anyway, by this time all I was getting from the left side was what is called residual sound, noise, but no discernible speech. However, it had to be used in order to stimulate the left auditory nerve, the one that goes from the cochlea to the brain. The brain is very big on modifying what you don’t use, so despite being a pain to decipher speech with the accompanying white noise, I knew I had to wear the darn thing. The end game was becoming obvious, which brings us to this time last year, when I made the decision to apply for a cochlear implant.

More to Come

Jim