Cochlear America CI Program
Presented by Curtis Humphries
Editor: Curtis Humphries was the featured speaker at the San Diego
Cochlear Implant Group meeting in March of 2007. He discussed the latest
equipment from Cochlear and the importance of Bilateral Cochlear
Implants.
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The cochlear implant (CI) is a wonderful device that is helping tens
of thousands of people live more complete and fulfilling lives, by
providing them access to communication. But despite these numbers, less
than 10% of people who could benefit from a cochlear implant have
received one.
Last year Cochlear launched the Cochlear Awareness Program to educate
people about the benefits of CIs. The ten regional managers (including
me) recruit and train volunteers to help in this effort, and we're
working very hard at it.
One other thing I do to get the word out is to talk to people about
CIs whenever I can. I fly a lot, and whenever I get on an airplane, I
make sure that when I get off, at least five people on that plane know
about cochlear implants.
I got my CI about four years ago, and it changed my life. I had been
in withdrawal, had stopped socializing, and stopped going to movies.
Since I got my CI, I've been living a much more complete and satisfying
life.
I also want to talk about going bilateral - not just bilateral CIs,
but bilateral hearing. I wear a CI in one ear and a hearing aid in the
other. When I first got my CI they told me to stop using my hearing aid.
That was the conventional wisdom back then. I did that for about three
months, but then I insisted on wearing my hearing aid in the other ear.
And now I think the audiologists are recommending that, as well.
Our Freedom processor has been out since 2005, and it's backwards
compatible with every array we've produced for 25 years. That means that
anyone who has a Cochlear CI can upgrade to the Freedom without surgery!
I got my Freedom last year, and I just love it. I get about 18 hours
from the rechargeable battery, Note that how long your batters last
depends on your coding strategy, because some use much more power than
others. I can also use disposable batteries. The standard behind the ear
(BTE) processor uses three disposable batteries; the mini-BTE, which
lacks an Accessory Port, uses only two.
Our current electrode arrays include a chip which is not currently
used, but will be available for future use.
Our CIs are approved for MRI testing up to 1.5 Tesla, with the magnet
removed.
Our CIs are very reliable. The N22, which is our oldest technology,
has had a cumulative failure rate of less than four percent, and most of
these devices are well over ten years old. Also, virtually all of the
failures have been with the processors, so surgery is not required to
correct them.
The Freedom Speech Processor can run for up to 5 days on disposable
batteries. It has built-in help messages, volume and sensitivity
options, a built-in telecoil, and four programs.
One of my programs is called "Beam". This is basically a
directional microphone, and I can control both the distance the
"beam" reaches and how spread out it is. Other programs
include Auto-Sensitivity, which is great for noise, ADRO, which works
well in a dynamic acoustic environment, and Whisper, which is for soft
and distant sounds. One place I use ADRO is at the movies, and I'm able
to understand about 95% of the dialog.
For those who are interested in performance measures, one test we did
on Freedom users used the CNC Words in Quiet test. The average result
increased from 45% correct at three months, to 53% at six months, and to
62% at 12 months.
Cochlear is also very interested in people's reactions to their
special processing. One test, conducted on a group of folks 12 weeks
after implantation, used the CUNY Sentences in Noise test. In that test
85% of people preferred one of the preprocessing programs (ADRO, BEAM,
etc.).
In another test conducted in the presence of noise, people using the
standard processing scored about thirty percent correct, but improved to
over eighty percent when using the BEAM preprocessing.
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It's very important for people to have stimulation to both ears, whether
they have or will get a CI or not! People who get CIs are generally
successful much faster if the implanted ear has had continuous access to
speech.
Following single sided implantation, the use of a hearing aid on the
other side generally improves speech perception in both quiet and noise,
and it provides complimentary information for both speech and noise.
This practice is much more common today than just a few years ago, with
about 80% of adults using hearing aids in the unimplanted ear.
As with hearing aids, some people think that CIs restore hearing.
Those of us in the community know that it's simply not true. They are
wonderful devices that have enriched tens of thousands of lives, but the
do NOT restore anything like perfect hearing. I recently saw a
demonstration of that at an elementary school that has a lot of
prelingually deaf kids. When the teachers started using lapel mics with
feeds to the CI's Accessory Port when reading, the kids' speech improved
more rapidly. But when the kids themselves used the mics as they read,
the improvement was more rapid still. The message here is that it's
always a good idea to give the CI user access to the clearest speech
possible.
Research is confirming what we have long suspected - that people with
bilateral implants do better than those with a single implant. This
seems to be the case in virtually every study that has been done and
with virtually every measure of performance.
Q. Some insurance companies refuse to pay for a second implant. Will
Cochlear help us work with them?
A. We have recently upgraded our reimbursement department, and will help
you appeal if you are turned down. We are also working with the Let Them
Hear Foundation to promote bilateral implants. Medicare, Medicaid, and
the VA do not pay for bilateral implants right now.
Q. I have the N22 and was upgraded to the 3G Processor several years
ago. Can I now upgrade to the Freedom processor?
A. Yes, that upgrade will be available this year. And it's just a
processor upgrade. You don't need surgery to do the upgrade.
Q. My daughter had the 3G and has been upgraded to the Freedom. We're
keeping the 3G processor as a backup. Is that a good thing to do?
A. We don't recommend it. Generally after people get used to the Freedom
processor, they don't like the sound they get if they go back to the 3G.
