Part 2 - Dinah’s Cochlear Implant Journey

We’re following Dinah, one of my patients, in real time as she goes through the process of having a Cochlear Implant (CI). This should appeal patient and audiologists alike, as I tell both sides of the story.

Part 2 - Assessments

The assessment process began in mid February, when Yorkshire Auditory Implant Service (YAIS) received my referral letter. They asked me to send a more detailed report so they could check if Dinah fitted their criteria for an NHS cochlear implant operation.

The criteria* are a set of rough guidelines, whereby your hearing test results must have two points that fall into the red area on the graph. So you will have a severe-profound loss, and it must be affecting the mid-frequencies (not just the very highest frequencies, which is very common as we age).

Unless you developed a sudden hearing loss, you will be expected to have already tried hearing aids thoroughly. Dinah has been wearing aids for years and we have genuinely reached the stage where we just can't get good enough results for her with them. As there is no upper age limit on having a CI, she sailed through the referral stage and was accepted for further testing.

Example audiogram

Currently the NHS in England will only pay for one implant. On the other side you'll be expected to wear a hearing aid - which we'll be talking about in future posts.T

he first appointment at YAIS saw Dinah having a normal hearing test. She also had a special hearing test for speech recognition in noise, where you listen and repeat sentences as you hear them. They are played with rising levels of background noise, and you get a score for the parts you repeat correctly. As expected, Dinah scored poorly on this test - this is why we are going for a CI!

Dinah then had a CT Scan of the side of her head where the implant was to be fitted. She saw a specialist rehab audiologist who explained thoroughly what the rehabilitation procedure would involve. She says, "They are wanting you to be really committed to the process before they go ahead with the op, so that both they and you know that it's what you really want. I really want the implant and you'd already explained a lot of the process to me, so there was no problem there!".

Next came a detailed balance assessment, which Dinah explains as being... "quite long. They poured warm and cold water into both my ears, which made me a bit dizzy. I had to follow lights with my eyes while a camera looked into my pupils. They recommended I got a taxi or a lift to and from the hospital for this one, and I'm glad I did!".

Caloric Testing (Part of a Balance Assessment), courtesy of Timothy C Hain, MD.

Then came another meeting with Audiology to discuss and choose from the available implant styles, and a meeting with the surgeon to sign the consent forms. Dinah has selected the Cochlear Nucleus Kanso 2 for her operation. This is an off-the-ear processor which sticks directly to the skull via a magnet (some processors have two parts abd resemble a large hearing aid, this one is a single disc).

This takes us up to the end of June, and the next step is the operation itself on 19 August!

"There have been a lot of appointments over the last 4 months, but the team have been great", says Dinah. "They have scheduled appointments on the same day wherever they could, to avoid me having to travel. I've been in about 5 times altogether, and there'll be more to come after the op, but they are all lovely people".

COMING UP IN PART 3

The Operation Day!

*Criteria vary from region to region, and if you are struggling it is worth asking your audiologist to contact the local implant team to discuss you individually. There are exceptions to every set of rules, if the need is genuinely there and the patient will benefit.