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Sequential cochlear implantation...


Ivana Marinac

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Although we are talking here usually within the context of children population, I put it here on purpose so both population, both adult or parents could read about recent development in this field.

Recently the researches started to talk a lot about bilateral implantation within the same operation. But what about people who were operated before and went out of their "implantation's windows".

Please read:

 

1. http://www.audiologyonline.com/articles/therapy-same-or-different-for-7027

 

2. http://www.ncbi.nlm.nih.gov/m/pubmed/25946482/

 

3. http://www.ncbi.nlm.nih.gov/m/pubmed/23137855/?i=3&from=%2F25946482%2Frelated

 

Hope this will help! :)

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Great info Ivana! Thank you. The first article is especially helpful for understanding the goals and approaches in auditory rehabilitation (for both bilateral and unilateral users).

By the way/ I was surprised to learn that (at least in my area) there are not special specialists trained for CI auditory rehab. My audiologist told me that to start my auditory rehab I need to find any speech pathologist who feels comfortable to work with CI recipient.

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None here either

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I think my area may have at least one.  I know my doctor asked me that if I get the second implant, do I want speech therapy.  I said yes.  I haven't heard anything else about it, so I will be looking in my area to see if there is one.  I hope so.  Be sure to check the Speech Pathology department at local colleges....perhaps some will be willing to work with CI patients. :-)

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I would expect that such specialized speech pathologists are affiliated to a certain medical center. Surgeons still don`t fully understand the role of the rehabilitation in the process of the cochlear implantation. 

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I agree with Ivana that it would be smart to have a network of speech pathologists specialized in CI rehab affiliated to CI centers. So far, the situation looks like "pull yourself by your own bootstraps".

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Most definitely in the US, the necessary aural rehab is in place only for children. It is rare to find a CI center with aural rehab in place for adults. I agree that this is a shame. Everyone blames it on insurance reimbursement. I actually have insurance that would cover aural rehab but have no access to any specialized providers. This really should change. Adults need aural rehab options in order to get the most out of their CI experience too.

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It was never mentioned to me. I was told it was up to me.well the audis gave me some great tips as what was best for me to do. But it was up to me.

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My experience was the same as Kara. My audiologist gave me some handouts and then when I was home, my friend Judi, helped create all sorts of different "lessons". She visited everyday to help me and then I made sure I put myself in situations that I previously avoided.

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Sandy, you are lucky to have Judi. It is such a mission to help overcoming avoidance. My respect to both of you that you were brave enough to do that.

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Yes - friends are sometimes/often precious although they are not all the time around...:)

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  • 3 weeks later...

My ENT sent me to meet a speech pathologist when we decided to do the CI. She has worked with a lot of people with CIs and thinks I should have a pretty fast rehab although I'm not sure how long pretty fast is. I hear anywhere from 6-12 months.

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CIs are amazing devices but science has not yet figured out a way to anticipate our functioning with a CI prior to implantation. Studies show that one of the benefits of getting bilateral CIs is knowing that the "better ear for CI functioning" was implanted.

My CI team is awesome and my surgeon for my R CI is well respected in the field. He thought I would never get open set speech understanding from my right CI based on the imaging results before surgery. He is thrilled that he was incorrect. I have awesome speech understanding even when I can not see the speaker (phone, etc) in that ear.

The surgeon's job includes selecting the most appropriate electrode array and surgically implanting our CI in the best possible position.

The audiologist's job includes creating programs (MAPs) that give us access to the range of sounds that our implant provides.

Our job (with a therapist or solo) is to do the necessary aural rehab to teach our brains how to use this new sound input.

When everyone does their job well, we get the most benefit from our CIs.

As far as dedication and time involved, our job requires the most time and practice. Stay focused. Stay positive. Listen to your body and take rests as needed. Know going in that this is a marathon, not a sprint.

Standard answer is that rehab requires 1 year. Reality is that everyone's journey is unique and many, many CI users report increases in functioning well past the 1 year mark.

Best of luck.

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I would also agree that it is not good to make predictions in numbers - this only burden the rehabilitative process, make pressures which are not good. 

Your brain will show how much of its capacity will employ regarding your rehabilitation - you will move the borders. ;)

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Well guys, since my activation last Thursday I have been busy! Both of my sisters and my son came on Friday to check it out so I had about 4 hours practice listening. I went to church Sunday and could follow and hear what was printed and some parts that I know but the homily and music were both a total bust. I know, patience! :-) I have now heard the cicadas, birds, the neighbors dog barking and wind flapping our patio umbrella and my husband only repeats once when he rembers to slow it down instead of three four or five times! Wonderful! I have also been practicing with the exercises on the app Mary Beth directed me to. Thanks Mary Beth I appreciate your help. Thanks to all for your help and encouragement.

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Kay,

You are welcome and it sure sounds like you are off to a terrific start! So much changes so fast in the early weeks! Enjoy your journey. Please keep posting updates. It is fascinating to read about everyone's unique hearing journey.

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We ate on the patio tonight and I discovered that the chimes I hear when someone speaks was gone out there. I wonder why?

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Did the chimes start back up again when you came inside?

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They did but they're getting quieter. my audi said they were caused by the nerve endings being stimulated after a long absence of stimulation so they don't know what to do. He said it will get better. Seems to be so. Just strange that they were silent outdoors.

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