Cochlear Implant Switch On

I had to wait a few weeks before my Cochlear Implant was switched on / activated. Those few weeks were very tough, basically watching the world go by with mute turned on. You feel disconnected from the world. I found those few weeks challenging. Now, I am about 5 days activated.

Activation day is always regarded as a milestone. The natural expectations for switch on are typically high, for me I am not sure what I was expecting. The advise is do not expect too much too soon, i.e., have low expectations. I kept repeating to myself - have low expectations. Get through switch on, and absorb some sounds and hopefully understand a few of those sounds, and maybe understand a few words.

During switch on the audiologist played several "beep" sounds, at different frequencies, and these were the first sounds I had heard in two weeks. It's the only time that beeps sounded amazing. At least now I knew that the implant's technology was to some extent "working", i.e, the electrodes were firing electrical signals to the auditory nerve.

Once we finished with the beep sounds and were comfortable with the volume of the beeps over several frequencies, we moved to enabling the device to transmit all sounds. Within the first few seconds I heard words, I would describe it as a robotic voice, this was the audiologist speaking, after a few minutes I would say I was understanding 80% of the sentences. I was not understanding all words, but I was understanding the sentences and I could have a comfortable conversation with the audiologist. It's important to note that we are in a "perfect setting", a room with no other distracting background noise. My wife was there too, and she spoke, and her voice sounded exactly the same as the audiologist, i.e, I could not distinguish voices or accents.

We continued to chat about expectations, the device and it's accessories, and also what might happen over the following week with respect to absorbing sounds. Within about 30 minutes I began to distinguish voices i.e., I knew when the audiologist was speaking and when my wife spoke. I started to hear all various sounds in the room, such as keyboard typing, mouse clicks, rustling of paper, movement of bags and so on. Overall, switch on / activation was very positive. The audiologist considered the switch on very positive.

All sound is like the sound that comes from listening to one of those kid's microphones they use for singing, it's crackly, robotic and not quiet tuned in. There tends to be an echo or shadow sound going on. But this should improve over time.

I left the clinic and headed back to my sister's house, I was able to hear differences in people's voices. I could now have a reasonable conversation and understand sentences, of course I didn't pick up on all words and when more than one person spoke, it was tough to understand.  

I am now several days after switch on, and I am picking up new sounds each day. Each day sound seems to be improving. It takes time as the neuroplasticity kicks in, and new neural pathways are developed. Even though I would have developed these neural pathways before (as I am post lingual deaf), neural pathways are not perpetual, and so the brain needs to redevelop these, and this takes time.

It's interesting listening to different sounds in different environments. For example, in the local supermarket the music is all muffled and its like a low humming sound (like a car engine).

Some every day sounds that I have only started to hear:

• Toaster button; the button you use to decide how "toasted" the bread should be, it makes a "clicky" sound. Never heard that before.
• Air-fryer timer; our air-fryer's timer is mechanical, I can now hear the tic, tic of this.
• Keyboard typing; my MacBook actually has a very satisfying click sound as I type, I have not heard this so clearly before.
• Car; several new sounds in the Car, when I select the EV mode and if the battery is not sufficiently charged I hear a "beep", previously I only knew the battery was not ready by reading the output on the dashboard. The air conditioner makes a noise, its actually pretty loud in my car.

I am still struggling in many situations:

• Cafes / Restaurants; At the moment there is too much background noise to understand speech.
• Wind; As I walk outdoors wind is very challenging, but it's far better than previously with the Hearing Aid. I know wind is going to be one of the biggest challenges.
• Road noise; my first experience was a two hour drive, this was terrible. All I heard was a low frequency humming, and I could not understand anyone in the car.
• TV; I watched a game, I couldn't pick up any of the commentary during the game this is mainly because of the noise of the crowd, it was all a "humming" sound. The half time analysis (when there is no noise from the crowd) seemed to be reasonably good, I could understand about 70% - 80% of the analysis. I tried Netflix with subtitles, and oddly one actor I heard pretty well (with the help of subtitles) while the other actor was impossible to understand. I find if there is background music / sound playing while an actor is speaking that this is very difficult for me to pick up what the actor is saying. I am hoping over time this will improve.
• Music; Close to impossible right now, I have the music streamed to the CI, and it feels like things are broken, every now and then I pick up a word or two, and I might recognise a part of the tune.I know music is probably the biggest challenge that I will have over time.
• Podcasts; I tried a podcast that I usually listened to, and I thought their was a stand-in presenter as I did not recognise the voice at all, it sounded female, and the presenter is male. I did not understand any words or sentences. A day later I could recognise the voice and it was the usual male presenter's voice, and I started to understand some of the words.
• Microwave beeping; Currently sounds like a basketball bouncing, this is very odd sound as before CI, I did hear this sound clearly.

As I am only 5 days activated, I am very positive to where I will be in 3 months, and this has really encouraged me to progress and find a way to get a second implant. The plan remains the same, for the remainder of 2023 continue focus and rehab on the implanted ear, and then 2024 push and find solutions for a second implant.