What’s new? It's been a while since my last post

So we meet again, after 2 years since my last post, a lot of things have happened and I would like to share it with you.

In 2011 I got an amazing job as an adviser at a local Cochlear distributor in my country, Adrial Médico Quirúrgico. Main part of my job is to guide cochlear implant candidates and recipients based on my experience as a CI user and the training that I have in the area given by Cochlear.

When I first meet a CI candidate that is going to buy an CI to our offices I don’t try to be like a salesman: if you buy 2 cochlear implants the third one is for free, no! Is not like that at all… I am familiarized with the prices but I do not talk about any topic of the sales department, that just would send the wrong message to the candidates and their families and I’m just an adviser, a guide in this amazing journey they are going to begin.  My work is based on 3 steps:

1. Getting to know the person in front of me: what is his/her story? How old is he/she? Who is his/her family? And…. Let me stop right here! With this I’m trying to know what happened before they started losing hearing. Or he/she was born deaf? How this hearing loss or deafness affects the family, friends, co-workers, but most important himself. What are his/her expectations about the CI? What are his/her aspirations in life? And if it’s a child that I’m trying to know depending of his/her age I try get the answer my strategy change, I love to to some playtime, if it’s a toddler again, like I said before I change my strategy and try to get to more the mommy this time. That’s how I get to know the real person in front of me!
2. To know the exact diagnosis of the candidate: a toughy one, oh yeah! Because you have of this medical terms and also, you have to have some knowledge in the field of audiology. I’m not an audiologist, but been able to work in this company has bring the opportunity to learn the diagnoses for hearing loss, I've been in CI surgeries as an observer to learn the surgery process live, and being trained by Cochlear also completes me in a way the I can at least understand what the candidate are talking about when they share their diagnose with me.
3. Cochlear implant introduction: Based on the information I have now from step 1 and 2, here comes the basics of the cochlear implant Nucleus 6 or CP810 the latest technology and how this is going to change his/her life for good. In this step I see how after I present the CI information to them how their expectations take place and as adviser try to give them the best guidance so those expectations don't sabotage their hearing learning experience.

What about recipients? Well, I have a volunteer network and we work in Cochlear Awareness across country so the information about Cochlear CI can reach to those who need the most. And also I give them training in: how to use the remote control, how to improve hearing in noise environments, to use the phone, to keep clean the sound processor, to improve hearing when listen music, and the list continues because it depends on what the recipient needs.

It’s been very rewarding to do what I do in Adrial, I can continue typing of what I do there and just be happy to do share it!

Here are some pics of my job! He he! As working lady!

But, that’s not all… I started studying psicopedagogía it’s similar to educational psychology. I’m now 2 semesters away from graduate! It’s wonderful to study this because completes what I do at work. Sure, you’ll know what is psicopedagogía? Well, is a branch of psychology that studies the cognitive and emotional development of individuals from infancy through adolescence and how this affects their learning acquisition process.  It is able to detect early signs of learning difficulties in their schooling.

I guess, I miss something very important to share with you… Last December I upgrade to Nucleus 6! :D I have a story for that! he he!

Stay connected to my blog and I’ll share my upgrade experience very soon!

Upgrade to Freedom to Nucleus 5

I´ve been losing hearing from age 17 due a progressive bilateral hearing loss. Nowadays I’m deaf. At that moment I could no longer understand movies without captioning and had to start relying on lip reading to communicate with people on a daily basis. It took a long time for me to finally accept my hearing loss. Besides my deafness I had other symptoms like, dizziness, headaches, disorientation, and my ears were ringing all the time. The diagnostic for my illness is called tinnitus. I was feeling very sick.

For me this whole thing of being deaf wasn’t easy to deal with, because I was losing one of my senses and this make me feel so bad.

I was implanted and activated 2 years ago and my hearing experience has been amazing!! I really started hearing again 6 months after the activation. The first sound processor that I had was Freedom; thanks to it  that communicational barrier stop existing and I had the chance to re-learn the sounds like my dog barking, the doorbell and even my own voice which I didn’t like at the time because it sounds funny like the chipmunk from the movie.

Then I learned about the N5 sound processor. It’s the smaller in the industry, improves your hearing in noisy environments, it’s water resistant and it has a remote control that lets you know graphically any failure in the S.P., you can switch to telecoil and programs established. The sound quality it’s unbelievable everything sounds so clear and Sharp it makes me feel like a hearing person again. In fact, The N5 s.p. allowed me to recognize sounds that I took for granted before I loss hearing like: the sound of the wind, the sound of a kiss, the sound of my own steps, my voice sounds nice it doesn’t bother me know.

I know that for some people or hearing people may think it’s silly but I have a dream and that is to listen the sea again and the sound of waves breaking on the shore. It will be very rewarding for me because brings me so many beautiful memories of my childhood, when my father used to take my brother and I to the beach to enjoy those sounds and relax. I’ll tell you my experience with this in an upcoming video.

I can tell you that I’m very happy with my C.I. is the best decision I ever made, thanks to my C.I. I feel confidence with myself again.

My testimony!

Service dogs for HOH or deaf people

Service dogs for HOH or deaf people do an amazing job by helping them to have a better way of life.

I wonder what happens when a deaf person (who has a hearing service dog) decides to have a CI. So a few weeks ago I wrote an email to a service dog organization asking these questions:

1. - What happens when after providing a hearing service dog to a HOH or deaf person that person decides to have a Cochlear implant? Do you take away the dog from that person?
2. - Is a unilateral CI user a candidate for a service dog?

And they answered:
“If a hearing dog recipient got a cochlear implant we would not take away their hearing dog. A CI may be switched off at times (e.g. when swimming or showering or sometimes at night to save batteries) rendering the recipient completed deaf. Also, it must be remembered that a CI is not a cure for deafness - a CI may be only moderately effective to a deaf person and so a hearing dog may still be very helpful in alerting and locating certain sounds to a CI user. However, if someone coped very well with a CI, Hearing Dogs and/or the recipient may decide that it would be unnecessary for the CI user to have a successor dog once the first one retires or passes away.

Current CI users may also apply for a hearing dog. Each case would be assessed on an individual basis. It should also be noted that a CI user must let the Hearing Dog work by alerting them to sounds, even if the CI user can hear those sounds (e.g. doorbell) most or some of the time.”

I'm not looking to have a service dog as I already have a “gifted” service dog. He is a black Labrador, a natural-born service hearing dog. He had no training and yet, he knew something was wrong with me so he was and always is aware and alerts me of any sound. He is my support.

I’m so glad to have him in my life because sometimes when there is too much noise and I’m walking along with him, I get disoriented and he takes the lead and guide me. And I get disoriented because I only have one hearing device… Onyx is the CI in my other ear – he, he! - It’s like I’m hearing through him!!!

CI users and their families

Hi everyone! Today’s post it’s about CI users and their families.

Having a cochlear implant is a life changing experience that affects your wife/husband, family and friends.  And it’s an adapting process for all…

The first days after the CI activation are the most difficult ones because you and your family have high expectations and that can put unnecessary pressure on you; to avoid that get closer to your family asking them to be part of your progress and to learn how they can best help you. Also, explain what you are hearing and how do you feel with that…

Make your family and friends become your allies; if they experience more of what you are experiencing, they will learn what to expect from a CI.

How to help a deaf person with CI

1.    Make sure that they are paying attention before trying to talk to them.

2.    If you are across the room go over to them and touch them in the shoulder, so you can have their attention.

3.    Do not shout at them. Sometimes when people shout at us the words sounds distorted.

4.    Never open a new conversation when another one is going on, you can confuse them.

People don’t realize how difficult can be to hear in social situations for a CI user and do not put pressure on the person concerned to attend if they really don't want to. It’s very 

uncomfortable for us.

While we are adapting to the CI and learning to hear/ to hear again those things I mentioned before are the key for a successful recovery.

Listening and Hearing, Not the Same for Children with Cochlear Implants (take it from Medical News Today)

Cochlear implants can allow profoundly deaf infants to hear speech - giving them the chance to eventually learn spoken language. However, a new study shows that the children receiving the implants don't automatically know how to listen when people speak to them.

Research presented this week at the Acoustical Society of America research meeting, showed that deaf babies with cochlear implants spent the same amount of time "listening" as normal-hearing infants of the same age. However, these children with implants spent less time than younger normal-hearing infants who had the same amount of hearing experience.

Cognitive psychologist Derek M. Houston, Ph.D., associate professor of otolaryngology and Philip F. Holton Scholar at Indiana University School of Medicine, said the insight would have implications for therapy for children receiving cochlear implants.

"When infants are born deaf, their development is shaped by a silent world. They learn to tune into the sights, smells, and touches that are relevant to them in their environment - but not the sounds," said Dr. Houston. "When they receive a cochlear implant, their world changes and are filled with sounds. But for these infants who have already begun to adapt to their silent environment, sounds may not - at least at first - be perceived as relevant to them."

In other words, they may hear the sounds around them but not have any motivation to focus on them, which slows their ability to learn speech and can be traced for years through word recognition testing.

Children with cochlear implants and normal-hearing children were tested in a sound-proof lab at Riley Hospital for Children at IU Health.

"It has been well-established that infants will look longer at a simple display - the checkerboard pattern - when hearing something they are interested in," Dr. Houston explained. "I measured their 'looking time' at the pattern when it was paired with a repeating speech sound, and compared that to the looking time at the same pattern with no sound."

Children with cochlear implants spent less time looking at the checkerboard pattern than children who could hear from birth. Furthermore, two years after implantation, children who were less attentive to speech early-on performed more poorly on a word recognition task.

An abstract of his research is available at http://asa.aip.org/web2/asa/abstracts/search.may11/asa220.html

Source: Indiana University

For Some Who Lost Their Hearing, Implants Help (take it from The New York Times)

I want to share with you this interesting article.

By JANE E. BRODY Published: October 3, 2006

Jenni Ewald and her husband, Russ, both lost their hearing as young children after bouts with meningitis — Jenni when she was 1, Russ more gradually starting at age 3. They met in college, communicating with sign language and lip reading, fell in love, married and had a baby. But neither could hear their baby cry, at least not until Jenni got a cochlear implant at Loyola University Health System in Maywood, Ill.

Russ was so impressed with Jenni’s result that he underwent the same procedure a few months later. Now living in Tempe, Ariz., both Ewalds can hear their two young daughters.

As victims of profound bilateral sensorineural hearing loss — a destruction of the hair cells in the cochlea of the inner ear that transmit sound signals to the auditory nerve — the Ewalds were not candidates for hearing aids, which simply amplify sounds reaching the ear and depend on normally functioning hair cells.

But they benefited from an implant that makes it possible for profoundly deaf people to hear and learn to interpret speech and other sounds. Perhaps as many as one million people in the United States could benefit from a cochlear implant. For children born deaf or who lose their hearing before they are verbal, the implants enable them to learn to talk.

An Intense Controversy

The surgery cannot create normal hearing; people who receive it can hear but might be described as having mild or moderate hearing loss. That fact has rendered cochlear implants the subject of intense controversy. Many in the deaf community say these less-than-perfect devices can turn a healthy deaf person — who learned to communicate using sign language, lip reading or both — into someone with a hearing handicap whose self-image may be undermined.

Still, those arguments have not stopped some 100,000 people worldwide, including about 25,000 in the United States, from undergoing implant surgery. Roughly half of implant recipients are children. Well-known users of cochlear implants include the conservative commentator Rush Limbaugh; Jack Ashley, the well-known member of the British Parliament; and the 1995 Miss America, Heather Whitestone.

Miss Whitestone was nearly deaf for 28 years until she received an implant in her right ear at Johns Hopkins Medical Center in Baltimore in 2002, allowing her to hear the voices of her two young sons. Early this year she lost what little hearing she had in her left ear and, in August, underwent a second implant, also at Johns Hopkins.

But not everyone with profound hearing loss — uncorrectable with traditional hearing aids — is a candidate for a cochlear implant. Ideal candidates include people with severe sensorineural hearing loss in both ears who still have a functioning auditory nerve; those who have lived only a short time with hearing loss; those with good speech and language skills or, in the case of young children, those in a family willing to work hard to acquire speech and language skills through therapy; those medically able to withstand general anesthesia and surgery, and those who want to live in a hearing world and have realistic expectations about what can be achieved with a cochlear implant.

Dr. John P. Leonetti, a neurotologist at Loyola who performed the implant surgery for the Ewalds, said he depends on the evaluation by the audiologist, who tells him who is — and who is not — a good candidate for a cochlear implant. He said the need for cochlear implants is rising rapidly as the population ages and more and more people lose their hearing and cannot be helped by a hearing aid. Currently, Medicare reimburses only a fraction of the cost of the procedure, keeping it out of reach of many people. Insurance rarely covers the price of even one device, about $40,000, which does not include physicians’ fees, hospital charges and the audiologist’s services.

The Device and Procedure

After decades of experimentation, primarily in the United States, Austria and Australia, the first cochlear implant was approved for use in patients by the Food and Drug Administration in December 1984, initially only for adults and now in children as young as a year old. Special approval is sometimes granted for infants as young as 6 months.

Miniaturization of electronics over the years has resulted in a small two-piece device used in cochlear implants. One, consisting of a receiver and stimulator, is implanted under the skin behind the ear. The other is made up of a microphone, a sound processor and a transmitter that is placed externally over the receiver, held in place magnetically. In the case of young children, the sound processor may be worn in a hip pack or harness. No wires connect the two parts, reducing the risk of infection and damage to the device.

To create sound, the microphone picks up and amplifies noises that the sound processor then filters, giving priority to audible speech. The processor sends electrical signals to the transmitter, which in turn sends the processed sound signals to the internal receiver electromagnetically.

The receiver and stimulator convert the signals into electric impulses, which are sent to an array of up to 24 electrodes. They, in turn, send the impulses to the hair cells and into the brain via the auditory nerve. The two dozen electrodes must fill in for the 16,000 hair cells normally used for hearing.

Efforts are under way to improve the technology. Last week, the F.D.A. approved a system with 120 inputs that is said to enhance the ability to hear music and to improve hearing in noisy environments. It is called the Harmony Hi Resolution Bionic Ear System, developed by Boston Scientific Corporation.

A Two-Stage Installation

A cochlear implant is installed in two stages. The first involves surgically implanting the internal component into the cochlea, which permanently destroys any residual hearing the person may have in that ear. Though some doctors recommend implanting only one ear, bilateral implants typically result in better hearing. The main drawback of a double implant is the cost.

About four to six weeks later, after complete healing of the implant area, the second external part of the device is installed. This is accompanied by a lot of fine tuning to adjust the signals as well as many months and even years of audiological training and, for those who do not already speak intelligibly, speech therapy.

Without intensive therapy and periodic adjustments of the device, obtaining a cochlear implant is all but useless. An unequivocal commitment to a rehabilitation program — which, in the case of young children, necessarily involves a commitment of the parents — is essential to success.

But even with such a commitment, people who have been profoundly deaf for many years may have a harder time learning to interpret speech through cochlear implants because the part of the brain normally used for hearing can, over the years, become diverted to serve other functions.

Children born deaf who receive cochlear implants before age 2 generally do better 

with spoken language than those who receive implants at a later age, though the window of opportunity for processing auditory signals in the brain does not close until adolescence. The sound transmitted through a cochlear implant has a robotic quality, but over time and with electrode adjustments, the sound of speech more closely resembles the human voice. and the doorbell, chirping of birds, and other noises sound pretty much as they do to people with normal hearing, Dr. Leonetti says.