FAQ on Cochlear Implant

I'm sure that some of us have probably been asked a few questions related to our hearing device (maybe a little way too many times) by strangers, acquaintances, friends, colleagues and so forth. It does get a little tiring that you find yourself becoming vague in your answers, or even giving excuses i.e. none of your business. Sometimes, you just hide your hearing device (if possible) so that you don't have to entertain such questions.

However, this has slowly contributed towards some misconceptions about the deaf community. If we want to create a better society for ourselves, I believe that we have to be more open about our hearing loss so that people can understand us better. At the very least, we should do our best to acknowledge such questions and answer to our best knowledge, especially if the person is genuinely curious because he/she has never interacted with us before. Although it is not a conversation topic I am actively diving into; over the years I have slowly come to a realization that it is necessary.

There was this article that I had read a year ago; and this paragraph resonated deeply with me:

"People who lose their hearing are afraid to be open about it because they fear the reaction - the prejudice, fear of seeming old or stupid. But what really makes you seem old or stupid, I know now, is not acknowledging the handicap. The more of us who accept and acknowledge our hearing loss with dignity, who continue to participate in professional and social activities, who refuse to let our hearing loss define us - the more we will defeat the stereotype and stigma of hearing loss."

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Hence, I decided to compile a list of FAQ and also added some of my own experience to answer these questions. Perhaps after reading this, my fellow deafies may have a better idea on how to answer certain questions, or if you find these as valuable and convenient compilation, you can even send this to your circle of friends or family so that they can get a better understanding of the d/Deaf community. As a disclaimer, I am not saying we should answer every single question; I believe that every individual has the right to choose whether to answer. But as far as possible, we should do our best :-) So here we go~

Q. What is that thing on your ear/ What is a cochlear implant?

A. When it comes to this kind of technical questions, I try to explain in a layman term. Hopefully this is a simple enough explanation. A cochlear implant is an electronic hearing device that is suitable for those with moderate to profound hearing loss. Basically, CI tends to be for those who will not be able to benefit much from having a hearing aid.

As you can see from the image above, CI has two components: one internal and one external. The electronic device hooked around the ear is an external speech processor. It is responsible for picking up everyday sounds, and turning them into digital codes. The signals are then routed to the circular "Transmitter" coil as shown in the picture. The coil then transmits the signals through the skin to the "Receiver" which is under the skin.

Usually, a surgery will happen to implant the internal receiver into the head. It is responsible for converting the signals into electrical impulses and sends these impulses along the electrodes in the cochlear. The electrodes then stimulates the hearing nerve, which then sends the impulses to the brain to be interpreted as sounds.

In summary, a CI is a hearing device that helps me to hear better :)

Q. What is moderate/ profound hearing loss?

A. They refer to the extent of your hearing loss. The severity of hearing loss differs for each individual so the least affected would be mild, followed by moderate, severe, and lastly, profound.

Q. Does profound hearing loss mean you can't hear anything?

A. Yes, the world is truly silent. You really don't hear a single sound at all. Since I have profound hearing loss, my audiologist tested my hearing and said that I can only hear sounds when it is equivalent to that of a bomb explosion :") That's how loud the sound has to be for me to pick up even a speck of sound! But this definitely does not mean you should throw bombs at me, just saying.

Q. If you cannot hear anything, how do you take shower/ sleep?

A. Well, it's real simple. I just remove my external processor. As you can see in the above picture, it takes two hands to clap. We need both the external and internal device for us to hear; without either one, we won't be able to make use of CI. The external processor is only held in place via weak magnetic forces, meaning it is removable. The internal receiver is already surgically in my head so it doesn't really get affected (unless I get hit in the head with a hammer; which I'm sure it is not just me but all of us will have more than just a concussion issue with that). But of course, doing so would mean I am literally deaf and can't hear anything. So if I am in the bathroom, you can do things like switching on/off the lights to get my attention.

Q. How do you wake up if there is nobody home?

A. I have an alarm clock called "Sonic Shaker" that vibrates. Since I lived in hostel rooms, I frequently wake up by myself for class. It really works like a charm; I just need to put it under my pillow after setting the alarm and it will vibrate when the time comes. I am a deep sleeper but there is nothing like a good ol' shake to wake me up.

Q. When in lectures/ seminars/ classes, how do you cope?

A. I use a device called Roger Pen. It is basically a wireless microphone that transmits sounds to the hearing device and supposedly can be used by professors conducting the lessons. However, it is limited in terms of distance it can be from my own hearing device. Nevertheless, it really helps especially in group meetings. By placing it in the middle of the table, it can pick up the conversations from group members. I generally use it in group discussions, but otherwise, I just make use of my CI and clarify with my friends when in doubt.

Q. Why do some people not wear CI since it can help with hearing loss?

A. The situation differs a lot for different individuals. CI is actually a personal choice, not a must. Some may choose to be Deaf, because they believe that it is what they are born with. For others, it could be because their hearing nerves are just not capable of transmitting impulses. In effect, a CI-implant can only help with sending electrical impulses to the hearing nerve, but it is not capable of sending the impulses directly to the brain. Hence, this makes them unsuitable to get a CI-implant.

Q. What is the difference between deaf and Deaf?

A. This is an interesting tidbit I myself have recently discovered. Deaf (with the uppercase D) refers to people who culturally identify themselves as Deaf and engage actively with the Deaf community. They are usually born deaf and depend on sign language to communicate.

People who identify themselves as deaf (with the lower case d) refers to people who do not have a strong connection to the Deaf community and prefer to communicate orally than use sign language. So yes, there is a difference between these two terms.

Q. Can you sign?

A. This is an extremely common question. To be frank, there is this assumption that those with CI/ HA can sign because we have hearing loss and therefore belong to the Deaf community. In actuality, for some, like myself, tend to lean more towards the deaf community and oral speech, hence we don't know how to sign.

However, I do admit that it is important to know sign language because I feel that it is still a crucial part of our own unique identity. Hence, I've taken some lessons on sign language (hence I do know some) and will probably improve on it in the future.

Q. If you can hear, why did you need speech therapy?

A. This is also another misconception that when the CI is turned on, one can immediately enjoy the new sounds and understand conversation. In reality, hearing sounds for the first time does not imply that you can immediately understand or vocalize sounds. It takes time and practice to strengthen the hearing nerves. The longer you have been without sounds, the more likely the hearing nerves don't work as well as they should.

Frequently, after being in a world of silence for a long time, one would feel disoriented, confused or even irritated about the sounds when first implanted. Hence, there is a need for someone who can make a sound and tell you what the sound means. For example, "meow" is the sound of a cat. "Ahh Eee Iiii Oooo Uuuu" are vowel letters. Certain things like this require a speech therapist (or rather Auditory-Verbal therapy) who can develop your listening skills and tells you what symbolism the sound really means.

Q. Will there be any learning abilities difference between those born deaf and those who lost their hearing at the later part of their lives?

A. Okay this may not be a frequently asked question but I thought this would be an interesting follow-up after the previous question. So I googled and found a much clearer explanation:

"Recipients who lost their hearing later in life will have more memories and neural connections for sound in the brain. After they receive a cochlear implant, these memories can support them as they re-learn to hear with a cochlear implant. For people who have been deaf for a long time or children who have been born deaf, there is little, if any hearing memory. The new sounds are meaningless until this hearing memory is built up. Perhaps it is like being in a room full of people speaking a foreign language - it takes time to sort through the noise, attach meaning to the sounds and make sense of what is heard."

It implies that it takes much more practice for one who is born deaf than one who lost his hearing later on. But the learning abilities afterwards depend on the individual and resources he/she has :-)

Q. What are some of the difficulties you have?

A. As you can guess, noisy environment is the bane of hearing loss. We have trouble hearing over other sounds, and that sometimes drain a lot of our own energy to concentrate on the words spoken. For me, although I like energetic places, I do get tired easily afterwards because I have to put in more attention to the other person's words. Another kind of place that I dislike a lot is those with a lot of echoes. I simply find it harder to hear and understand my companion.

Another kind is that we (or maybe it is just me?) cannot tell the direction of sound. My family did an experiment before: my parents would make a sound while I closed my eyes and pointed in the direction I thought it came from. Turned out I got 100% - wrong. So yes, if you happen to call me and I turn around, I get bewildered because I don't know who called me. Would be really great if you could at least wave after I turned around. That also implies that I have to be pretty alert on roadsides since I don't know where the honks of cars and bicycles come from.

Water activities are also something more arduous for us since our hearing devices are susceptible to water droplets just like any electronic devices. Though it is slightly more waterproof than in the past, it still does not mean we can simply throw it into the swimming pool and expect it to emerge perfectly fine. However, I still swim perfectly fine, just without sound and that's fine with me! I probably won't make a good companion for Wild Wild Wet though... Anyway, I noticed that some of us are able to overcome this problem (i.e. water polo) and if you happen to be one, drop me a message on how you managed to do it (because I am curious about it too).

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I hope that this FAQ helped to shed some light on some of the questions you may ask/ find yourself being asked. Hopefully the information is easy to understand! I think I have covered the more common questions but if I have missed out any, please feel free to drop me an email and I'll answer them in the next post! I will also be writing about some tips that anyone can do for a d/Deaf friend.

Most importantly, kindly do not treat us any special from others!! Believe me, we can feel it and I think many of us don't like that. Just treat it like how you see people wearing spectacles; like how spectacles can correct our visions, CI/ HA can help us hear better. It is not a cure though, maybe I will elaborate that in the next post as well. We all have intriguing personalities if you just take the time to understand us better ;-) Stay tuned!

xoxo,

Claire