Thanks for sharing with us. I have recently gone from RICs to BTE slim tube HAs and it has made a big difference.
3 Likes
There is also a type of hearing aid that does something called CROS, which takes sound from the side of the bad ear and sends it to an aid on the good ear. This is to reduce the hearing issues associated with single-sided deafness. At least by audiogram, your good ear looks really really good.
3 Likes
One big thing to remember: You can get a hearing aid on a trial basis, you can not get a CI on a trial basis - it is permanent.
8 Likes
I have a different take on this. Yes, your hearing level seems to those on the platform to be too good for a CI. CI criteria has changed significantly in just the last 5- 10 years, so many people who have had CIs for a while had to wait until they were in the profound range before qualifying. I had my CI activated in December of '22 and am now 10 months into the journey and have never looked back. I was considered “borderline” to qualify because my low frequencies (see audiogram) were in normal range and then I tanked to profound. My speech understanding was about 40% in my left ear. With CI surgery there is a risk of losing what hearing you have left and I did lose mine. Some will say it is based on the surgeon, but it’s just a matter of your inner ear structure and luck. I went to Vanderbilt which is a leading CI research university and my surgeon said it’s 50-50 whether you retain residual. Research also shows that getting it sooner than later, while you still have residual hearing, can have faster brain adaptation because the brain is used to the stimulation. I had what they call “rock star” activation results - activation is when they actually turn your CI on a couple week after surgery - and could understand words right away. All sounds were like Darth Vadar in a tunnel for a month or so and gradually got more natural sounding. I am still noticing improvements as time goes by and those improvements can happen for a couple years after activation. I chose the Advanced Bionic brand over Cochlear and Med El due to what I considered advanced tech. Medicare and other insurances have raised the threshold very recently to allow coverage for those who still have a some hearing but have low speech understanding scores. Certainly you can get a second opinion - always good to do research and other inputs. I am not saying you should or should not, just that the criteria are changing rapidly. See this link for the new Medicare approval criteria for US: NCA - Cochlear Implantation (CAG-00107R) - Decision Memo
5 Likes
I do not have cochlear implants, but on two occasions I was just about pushed into getting them and I refused.
I have read and studied and had extensive conversations with my doctors about this.
It is very surprising to me that you would receive a recommendation for a cochlear implant without trying hearing aids first. The advances in the technology have been substantial over the years.
To qualify for a Cochlear Implant through medicare (I am 67), your audiogram has to be pretty bad. To me it sounds like your condition is bad but going straight to C.I.? I would get a second opinion.
There are many things said about recovery and I have had direct conversations with one of my audiologists (at UCLA), who has a C.I.
The surgery is outpatient. 2-3 hours and you go home.
The most common complication is called “Octave displacia.” I am a composer. I asked, an octave? Or a major third? In one ear? Both? No one can say.
Recovery times are generally shorter for older patients because their brain already knows how to speak and relearning is easier. For someone born with severely compromised hearing the recovery time is longer because they do not know how to speak.
Finding a good audiologist and getting a good audiogram is very important. I have had so many done I can’t even say how many. And by many different audiologists in two countries.
I can tell you the qualitative difference in them is vast and the importance of a good one is key to successfull programming of HA’s.
It is unfortunate that until recently HA’s have been expensive and controlled and hardly ever covered by insurance.
My ears are in the profound hearing loss zone and my last word recognition scores taken 6/16/23 show my word recognition in my right ear at 16% and my left ear 64%.
Finances. The good ones to help with clarity for severe word recognition problems are expensive. Well, you couldn’t buy the OTC hearing aids when my loss first declared itself. They are so much less expensive and I bet they are good.
Main issue: You want to communicate easily with your daughter. Your daughter will love you no matter what.
Costco has a well-regarded hearing aid center and has many brands. You can get an audiogram done there.
Try one of the higher end over-the-counter hearing aids and get them programmed. Explain clarity is the main struggle for you.
There usually is a return period. Take advantage of it. Use the HA’s in clubs, auditoriums, loud family gatherings, really test drive them and if they do not work return them.
I did not do this my first time around but I do now.
As a composer, there are two things that have made me wait. One of the most common side-effect is that you will never be able to play or hear music again. This is because of the octave displacia that happens with the surgery.
Try a high-end model of Oticons or Widex and return them if they do not work for you. Know we are talking about 6 grand.
If that is out of reach, get a high-end OTC brand (I have seen the top end OTC aids run about a grand and do the same thing.
Go to Costco. Get a second opinion. Try HA’s first.
They are better now. I wear behind the ear Widex Moments and no one ever sees them.
Take control.
6 Likes
Welcome to the forum.
I’m sitting on the fence with this one because today the theory is the sooner the better. You do need to wear your aid every day for at least 6 months. The CI evaluation Auds will tell you this also. They may even tell you to go home and wear it for 6 months then come back for testing. That’s how critical wearing your aid is to your hearing, as well as your brain. Why your brain? Simply with a CI your brain does all the work of what your ear used to do.
Generally speaking those people who don’t wear an aid in the opposite ear to the CI (bimodal) need to do hours upon hours of rehab. Or they don’t get the desired result. It’s a tough gig being a single sided CI. For some reason bilateral or bimodal CI recipients seem to do better than those with a single CI.
Good luck to you which ever way you decide to go.
4 Likes
Not cool. It takes awhile for the brain to adjust to hearing aid information. Word recognition is not (only) about volume.
You need to wear them regularly to have them work right. And as I mentioned in my previous missive, you gotta have an excellent audiologist perform the tests and understand your need - word recognition, and then have them programed, use them, go back for tune up. Put some work into it. You can make this happen. I think you have to seek out a new ENT/Audiologist team for a second opinion after doing a deep dive in your area, reading reviews. Find someone great. Put in the work. And love your daughter.
I am not a doctor but this whole approach you just described sounds completely off. Just my humble opinion.
1 Like
Lostdeaf is right. Just looked at your audiogram. Lost deaf’s recommendation for Oticons is good too - they have a reputation for word recognition. Goodness gracious I would die for an audiogram like that.
The key frequencies for vocal/word/peech are between 500khz and 1500 to 2000. That big dip at 4K doesn’t matter. 500khz to 2K is the zone. Roll off everything under 200 - you do not want lows making things muddy. Too much compression will make the spoon dropping in the kitchen 12 feet away louder than you talking to your daughter. Ahh - just riffing. You can make this work.
3 Likes
Hi, for the case in future you decide an implantation, please narrow the focus onto the best aftercare in your region. It will be necassary to adjust the Speechprocessor and perhaps to attent to special therapy.
I have replied before and agree with the general consensus.
The surgery is outpatient, 2 1/2 hours and well-tolerated in group studies. I will have to get bilateral cochlear implants soon and am spending time doing my own deep dives and conferring with my audiologist, ENT and surgeon.
And again, I cannot believe the recommendation for CI’s based on your audio gram. I simply do not understand how your audiogram would merit implant.
I am on medicare. Medicare will not approve CI’s unless your audiograms are SIGNIFICANTLY worse than yours.
Aftercare is important. Recovery can vary. Usually better with older people. 1 month, three months, a year. Believe me, when you need them this will not matter to you.
The reason for this new rmissive is to make you aware of a new Oticon product, shortly to be available in the US.
I am quite interested.
W
Addendum: the manufacturers of CI’s have no sense of style. Skins are available to make them not so butt ugly than the 6 or 7 colors usually offered.
1 Like
Oticon has already sold its cochlear implant division to the Australian Cochlear. So I wouldn’t recommend Oticon cochlear implant. Choose Medel, Cochlear or any other company.
I read about that. Am seeing audiologist to discuss. I am looking at many companies. Neuron 8 looks good for my situation.
my first thought too 
My advice is to get new hearing aids (or a hearing aid and a cross) and wear them consistently. It’s the only way to get used to them and get the full benefit from them. If you aren’t happy with the options from your current audi, find a new one who will work with you.
I really doubt you need an implant yet. A cochlear implant is surgery during which you will likely lose all the natural hearing in the implanted ear. You have SO much natural hearing left.
I’m not against implants in general. I recently had a cochlear implant (advanced bionics brand) and I love it after years wearing a a hearing aid and a cross yet still missing so much. I love my implant and for me, speech in quiet and music is already wonderful - beyond my expectations. (I’m still working on speech in noise.)
But if you look at my audiogram you can see the difference. You are nowhere close to my loss when I decided to get the implant.
1 Like
Advanced Bionics offers great colors. Mine are teal and I love them. Can mix and match covers, etc.
I’m probably the closest to your situation on this forum. SSD with total loss in right ear. I’ve used cros as a kid and more recently; I did not care for them or find them very beneficial.
I opted for a CI. For me, I will likely never have good word recognition with it. It has however given me sound awareness on my bad side. I’ve also already noticed an improvement in understanding sound in difficult situations, like restaurants. There is a lot more work that goes into a CI than I really expected. I was told this going into it however, experiencing it is deferent than hearing about it.
Now there will be people that say your hearing is too good for a CI, and they may be right or wrong; however, remember that hearing is very subjective. One person may have very poor hearing and still be able to understand conversations in tough situations, and another may have very good hearing and not understanding conversations in the best of situations. As such, a CI evaluation will help you find where you fall on that spectrum. So regardless, I’d recommend proceeding with the evaluation unless you’re happy how you are.
One thing that can help though is auditory training. Using an app like Hearos daily will help you train your brain.
Now, if hearing aids aren’t helpful to you, and you don’t want all the effort required for a CI, you may want to consider something like an Osia or Bonebridge. Either of these can be discussed with your Audiologist or surgeon after a CI evaluation.
6 Likes
The OP is a candidate for a left CI.
I would agree with the general recommendation to try a hearing aid first for a while, but honestly if a hearing aid doesn’t given him more than 35% clarity in that ear it’s probably going to sound like junk and he won’t wear it and then why worry about losing remaining hearing in that ear because without a hearing aid it’s not giving him anything anyway. Certainly there are risks to surgery, but that’s not the one I would worry about if hearing aid benefit fails.
CI outcomes are known to be poor after long-term bilateral auditory deprivation, but outcomes for long-term unilateral deprivation are less clear. I believe I’ve seen some early evidence a while back that good input to the auditory system from one ear may be enough to support function that leads to better outcomes than we’d previously thought, which may be why it is being offered in the case. Best to discuss with the CI team.
If the OP opts against hearing aid AND CI in the left, consider a CROS to access sound on the left without craning your neck, but realistically a Roger On with a Roger Focus in the good ear may be more effective in complex listening environments. Most individuals with long term unilateral loss have pretty good coping mechanisms for positioning people towards their good ear in quiet, it’s noise where things get hard.
3 Likes
Could you explain your reasoning for this comment?
Thanks
If you cannot get sufficient benefit from a hearing aid, you’re a possible cochlear implant candidate.
1 Like
But the OP gives up on hearing aids very very quickly.
Most CI centres require you to wear HA/s for 6 months first if they don’t already wear them unless NO hearing at all.
1 Like