[sasi] Cochlear implants and aids

[Theresa Winebrenner]

Jeremy,
Thank you for that long explaination. Now I understand better why people 
with Meniere's Disease have had success with the cochlear implants.

A question I have for my doctor in March is concerning the disorder that is 
associated with nerve damage that when one is in a loud environment, that 
the loud noise  is emotionally overwhelming. If I have this problem with my 
aids, will I have it still with the cochlear implant? Do you know?

Theresa
----- Original Message ----- 
From: "Jeremy Congdon" <unlikelypeople at gmail.com>
To: "'Dave Mack'" <dcmack2 at comcast.net>; "'sasi, (sight and sound impaired) 
discussion list'" <sasi at acb.org>
Sent: Wednesday, January 20, 2010 11:22 PM
Subject: Re: [sasi] Is This True?


> Here is a basic explanation of hearing loss, and after that a basic
> explanation of hearing aids and cochlear implants.
>
> Sound makes your eardrum vibrate, and the vibration moves through three 
> tiny
> bones in your middle ear, then to your cochlea, which is a spiral like a
> snail shell or a cinnamon roll.  Your cochlea is filled with fluid and 
> lined
> with hair cells of different lengths.  The different lengths of tiny hairs
> respond to different frequencies or pitches of sound.  When different hair
> cells respond to different frequencies, they stimulate the auditory nerve 
> to
> send sound messages to your brain.
>
> There are two major types of hearing loss:  conductive and sensorineural.
> Conductive hearing loss, which is less common, is caused by problems with
> your eardrum, ear canal, or the bones in your middle ear.  Sensorineural
> hearing loss is when the outer and middle ear are working fine, but there 
> is
> not enough response to sound inside the cochlea itself.  When people get
> older, they naturally lose some hair cells in the cochlea, usually the
> smallest ones, which respond to high-pitched sounds.
>
> Hearing aids all do the same basic thing, which is to amplify sounds so 
> that
> they will stimulate the cochlea more strongly.  Analog hearing aids
> basically amplify all sounds.  Digital hearing aids are more expensive, 
> but
> also more flexible, because they can be programmed to amplify more in the
> specific frequencies that a person has the most difficulty hearing. 
> Hearing
> aids are not like glasses, because they don't correct the problem of 
> hearing
> loss.  Even with the right hearing aid, it's still going to be harder to
> hear in noisy situations, for example.  But hearing aids can help many
> people to increase their ability to use their remaining hearing 
> effectively.
>
> Cochlear implants work differently from hearing aids.  They use a tiny
> series of electrodes to substitute for the missing or defective hairs in 
> the
> cochlea.  Instead of the hairs stimulating the auditory nerve, the
> electrodes do it.  The electrodes receive their instructions from a 
> cochlear
> processor, which looks a lot like a behind-the-ear hearing aid.  It has a
> microphone and a computer chip that controls how the electrodes stimulate
> the auditory nerve.  The sound a person gets from a cochlear implant is
> different from what they get from normal hearing or a hearing aid, and
> learning to use this new kind of hearing requires significant therapy with
> an audiologist.
>
> When people lose their hearing, the first step is to try hearing aids. 
> When
> hearing aids can't provide enough help, then the next step might be a
> cochlear implant, if a person is a candidate for that.  Many people can 
> use
> cochlear implants, but it isn't an option for everyone.  For example, I 
> have
> a severe-to-profoud hearing loss, but I can't benefit from a cochlear
> implant because I have a third, much less common kind of hearing loss 
> called
> auditory neuropathy.  That means that my auditory nerves (between my
> cochleas and my brain) are not working properly.  I can hear a lot of 
> sound,
> but it's very distorted, and I have a lot of difficulty understanding 
> speech
> and recognizing the sounds I hear.
>
> Now, for the issue of money:  Most insurance does not cover hearing aids.
> However, cochlear implants are often covered.  When I bought my first pair
> of hearing aids, I had to cash out my pension from my job in order to pay
> for them.  But I'm glad I did.  It's very important to think not only 
> about
> money, but about which hearing aids will really help.  If you buy less
> expensive hearing aids only because they're cheaper, then it's a waste of
> money because you won't wear them and they won't be useful to you.  You
> should only buy the hearing aids that will work with your individual 
> hearing
> loss.
>
> And Ruth and Scott are absolutely right:  you need to find an audiologist
> who will listen to you.  An audiogram does not describe real life, so 
> don't
> let anyone tell you what you "should" be able to hear based on the 
> numbers.
> Find someone who will take you seriously when you say what you can hear 
> and
> what is difficult for you.  Get a trial period of at least a week or two
> with any hearing aids that your audiologist recommends.  During that trial
> period, take notes about what was easier to hear and what was harder, and
> when you were comfortable and when things were too loud.  Could you use 
> the
> controls and change the batteries comfortably?  The audiologist should use
> that information when deciding whether it's better to adjust the current
> hearing aids or whether it would be better to try a different kind. 
> Anyone
> who just pushes you to buy hearing aids without listening to your 
> questions
> and priorities is going to be just as unhelpful down the road, too.  You
> don't want to be stuck with an expensive hearing aid that sits in a drawer
> because it's more trouble than it's worth.
>
> Sorry for such a long message!  I hope some of this information is useful.
>
> Jeremy
>
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