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A loud and clear solution

Appleton man is advocate for cochlear implants

Craig Johnson of Appleton was deaf in one ear with some hearing loss in the other. He received a cochlear implant in 2006. Contributed photo

Craig Johnson of Appleton was deaf in one ear with some hearing loss in the other. He received a cochlear implant in 2006. Contributed photo

A recipient of cochlear implants, Craig Johnson, of Appleton, has become a volunteer advocate for a cochlear implant company.

“As an advocate I am available to anyone who would like to talk about cochlear implants,” explained Johnson. “Another important piece of my role is to spread the word about options for hearing loss.”

Johnson lost his hearing after he was stricken with spinal meningitis at 2 years of age. “The disease left me completely deaf on the left side, and with some hearing on the right side,” he said. “I used hearing aids until later in life when my audiologist recommended a cochlear implant.”

“I did not know anything about cochlear implants until my audiologist said something to me,” said Johnson about one of the many reasons he has become an advocate.

In 2006 Johnson received his first cochlear implant for his left ear. With great success in using his implant, he underwent surgery in 2012 for a cochlear implant on the right ear.

“What a ride it has been for me since I did the implant,” said Johnson with a smile. “The first surgery brought hearing back to my left side, where I had never heard before. I decided to have a cochlear implant placed in my right ear a few years later (in 2012) when hearing aids were no longer doing their job.”

Johnson has a cochlear implant on each side of his head.

“What a thrill it has been hearing ‘noises’ that I have never heard before, like birds singing, and humming of appliances around the house. The implants have helped make conversations easier for me and also helped improve my speech, as I can now hear how the sound is supposed to sound. It has been amazing how the cochlear implants brought sound back to me.”

The following information about hearing, the use of aids, and how implants work were provided by Johnson.

How You Hear

Hearing occurs when sound waves reach the structures inside your ear, where the sound wave vibrations are converted into nerve signals that your brain recognizes as sound.

Your ear consists of three major areas: the outer ear, middle ear and inner ear. Sound waves pass through the outer ear and cause vibrations at the eardrum. The eardrum and three small bones in the middle ear – the hammer, anvil and stirrup – amplify the vibrations as they travel to the inner ear. There, the vibrations pass through fluid in the snail-shape structure called cochlea in the inner ear.

Attached to the nerve cell in the cochlea are thousands of tiny hairs that help translate sound vibrations into electrical signals which are transmitted to your brain. The vibrations of different sounds affect these tiny hairs in different ways, causing the nerve calls to send different signals to your brain. That’s how you distinguish one sound from another.

Hearing loss can occur in many different ways.

Some are born deaf, or have lost their hearing through sickness, like spinal meningitis or Meniere disease. Others are deaf due to prolonged exposure to loud noise or aging, countless ear infections or ruptured eardrums. The list of hearing loss can go on and on.

There is Help for Hearing Loss

Most cochlear implants are behind the ear, with a coil that is attached to a magnet that has been surgically implanted in the skin behind the ear. Contributed photo

Most cochlear implants are behind the ear, with a coil that is attached to a magnet that has been surgically implanted in the skin behind the ear. Contributed photo

First, many hard of hearing people will start with hearing aids, according to Johnson. Some wear just one, others two, depending on the hearing loss involved. Most hearing loss begins with high-frequency sounds. As the hearing loss advances, it works its way to the low frequencies, said Johnson.

Before patients are fitted for a hearing aid, they will have to take a sound test in a soundproof booth. The audiologist will play a series of beeps from low tones to high tones. After the hearing test is done, you are fitted with the best available hearing aids based on the sound test.

Hearing aids work by picking up sounds and amplifying them to the eardrum. All hearing aids are digital and use batteries for power. Hearing aids can help with a lot of hearing loss, but in time may not be enough. This is where cochlear implants come in, said Johnson.

A cochlear implant (CI) has two parts. First, a microphone that picks up sound is worn outside of the ear, attached to the head through an implanted magnet. The microphone transmits signals to a surgically placed receiver inside (behind the ear), converting signals to electrical impulses and sending them down to electrodes implanted in the cochlea of the ear. Finally, the brain registers the sounds.

Qualifications in order to get CIs have loosened up. Upon qualifying, there are many tests to follow. For instance, there is a probe test, where a probe is stuck into the cochlea and a series of beeps are played to determine if the cochlea are active and viable for the implant.

CT scans are also done to see how the bone structure is around the cochlea and ear. Some people are also given an allergy test to make sure they are not allergic to the material in the ear.

An outpatient service, the surgery itself is about two to three hours long, depending on the person. Most will go home two to three hours after surgery; few cases have to stay overnight.

The next morning, the patient goes back to the doctor’s office to have the band aids around the head taken off and then they are sent home to heal. All of this is done under general anesthetic.

Six weeks of healing time is recommended before the processor is put on and activated. Some people can get the processor on sooner, but in most cases, it takes six weeks of healing time.

The electrodes implanted in the cochlea have 22 different “array electrodes.” Each array electrode has its own function in picking up sounds.

Most processors are behind the ear, with a coil that attaches to the magnet behind the ear.

Based on the user’s report of loudness, an audiologist sets the minimum and maximum current levels of output for each electrode in the array. The audiologist also selects the appropriate speech processing strategy and program parameters for the user.

Then the audiologist will send you home to work your way back to hearing. For the first two years you will need to visit the audiologist every six months for programming of the processor, or what is called “mapping.” You are given four programs to use, called “music,” “every day noise,” “focus,” and “noise.”

These four programs can be changed to your liking by using a hand remote, which also allows you to change the sensitivity or volume. Changing and using the programs will help you hear better in different settings: for example when in church, the library, a café, or at the kitchen table talking. Whatever the setting may be, the user can change the processor to help them hear better.

It does take time; the CI does not just happen overnight. In some cases it can take up to a year before hearing starts to click, in others just three months. It just takes patience, and with time and practice, they will work wonders.

If testing finds a patient is not a candidate for a CI, another implant, called Baha, may possibly be used. The Baha is a small implant made of titanium that is inserted in the bone behind the ear. The implant magnet is attached and hidden beneath the skin, just like the CI.

A sound processor is then attached to an external magnet and attaches to the internal magnet. Sound is now transmitted as vibrations from the processor via the magnets to the implant, which then directs the bone to stimulate the inner ear.

Cochlear implants are for anyone, from babies at least 12 months old and up, to any age; there is no upper limit.

Johnson is available to anyone who would like more information or to talk to him about his experience with cochlear implants. He can be reached via email.

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