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Qualified for a CI 11/21/2012!!!!!


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It's Meredith here, I am from the USA. Last Wednesday (Nov 21st) I had my 2nd CI evaluation done. My first was January 2009 and I didn't meet the qualifications for a CI. This time I failed the test, which means I qualify for a CI!!!! I choose Med-El in Ebony brown to match my hair color. I have an appointment in January to meet with my surgeon and go over everything (which I am assuming will include a surgery date).


There are a few things that I need to seriously think about - one has to do with "where" will I have the surgery. Basically, the Med-El is new to the USA (I was told by the audiologist) and right now even though my local doctor started implanting with Med-El, the local CI Center still is in talks between Med-El and the hospital - the audiologist told me they have another meeting with the Med-El rep on December 19th, and she thinks the hospital will be getting on board with Med-El by the time my surgery happens, as they have been discussing Med-El for the past 2-3 months. I am not thrilled with hearing this at this point. My other option would be to go down to John Hopkins Hospital in Baltimore, Maryland and have them implant me there, Hopkins is one of the top CI Centers in the USA that is willing to implant me. However, it's a 3 hour drive one way (in good traffic), where as my local hospital is 20 minutes from me. I also have some other medical issues that my local surgeon and hospital know about (he did an ear surgery on me before).


2) The audiologist informed me that they (not sure who "they" she is talking about here) do not test the implant while in the OR to make sure all the electrodes are working. I do know a different implant company Does test the electrodes prior to leaving the OR. This has me a bit concerned as I don't want to end up with an implant that doesn't work from the beginning. Can anyone clear up this question for me please.


3) This is the big question - I am fortunate to have Medicare health insurance here in the USA. But it will only cover 80% of the whole surgery/implant, which will leave me to cover the remaining 20% of the cost on my own. I do not have any other insurance and at this point I have no idea what the cost will be for a CI, I hope to find out in January from my doctor. So, right now I am looking at ways to "fund" the 20% as I am pretty sure it will cost me at minimum several thousands of dollars, I just don't have that kind of money..as it is I am on a limited budget due to not being able to work because of a disability.


4) another minor thing is when I was discussing what I couldn't hear and how background noise makes it impossible for me to hear anyone. The audiologist said "with the CI you'll still have difficulty with background noise".


Because the CI Center hasn't worked with Med-El before, and I'm assuming that they have worked with the other two implant companies (Cochlear America and Advanced Bionics) I'm assuming they have no clue how Med-El works and all the programs that it comes with. Now she did have the Med-El Demo kit in her office and was showing me the pieces and did discuss some of the options like the batteries and rechargable v standard. I was able to pick out the color (Ebony), I'm not sure why she was able to show me the demo kit since they haven't done anything with Med-El (does this make sense). So I guess in a way I am hesitant to go there for mappings and follow up. Though if I get my surgery done at Hopkins, I will be committing at least a full year to them before I can transfer my future mapping sessions up here to Delaware.


Don't get me wrong, I am thrilled that I finally qualify and will be able to take control of my life again. I am hoping to get my CI in time for my next birthday which is April - which means either a late Feb or early March date (was told it would be about 3 weeks between the surgery and the activation period).



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Hi Meredith,


I have already sent you contact information for the MED-EL Clinical Account Manager in your area as well as a reimbursement specialist who will be able to answer your questions about your CI center's relationship/experience with MED-EL and reimbursement issues, but I did want to address a few important points you have mentioned in your post:


MED-EL is not necessarily new to the USA. MED-EL cochlear implants have been commercially available in the United States since August of 2001. And MED-EL US clinical trials began in 1997.


You mentioned the audiologist told you that the implants are not tested in the OR but that other implant companies do. To clarify, testing of the electrodes in the OR is done through what we call telemetry. This can certainly be completed with our software, and many implant centers do choose to complete this testing in the OR prior to closing up the patient. It may be the case that this particular clinic has chosen not to complete the testing for any of the implant manufacturers. This is a good question to ask the CI center and the MED-EL representative for Delaware that I have specified for you in a private message.


In regards to background noise, that is one area which implant users can find challenging. We certainly hope and anticipate that you would see an improvement in your hearing in all conditions with the implant compared to pre-operatively. There definitely are many changes that can be done in the software to give you the best sound quality possible for all hearing situations.


I hope that helps to answer some of your questions. Please don't hesitate to contact me should you have more. The best of luck to you Meredith! We look forward to having you join the MED-EL family!

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Congratulations on becoming an implant candidate! It's going to be wonderful for you.


One thing I've found about background noise: once you're "turned on", you'll be able to use the "remote" thingy to expand or decrease the vocal area. That works great for eliminating a lot of background noises. It takes a bit to figure out what works best when but don't ever be afraid to use the adjustments and try the various programs you will be given to start and then have added as your years of implant use continue. I've had my implant for 3 1/2 years now and I'm still getting something new and/or adjusted at my yearly session.  It's part of the way the brain adjusts, what you're doing in life, and how well you handle the different frequencies.  Everyone is a bit different, so there's absolutely no "one size fits all". Thank goodness Med-El is so adaptable!  Also, each physician and clinic does things slightly different.


I know what you mean about the insurance coverage also. I was really scared to think about what my balance would end up, but my insurance had an out-of-pocket cap which helped a lot. Check your policy for that because it definitely limits your costs.

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Congratulations! There is a lot that I can't answer in your original post, and I'm sorry about that! About the background noise, that can still be an issue, but it's going to be very individual. And it may take a while to get where you will be, depending on hearing history, etc. I am 7 weeks post activation today and I can tell a difference between my hearing aid and my implant in loud situations. The implant sounds better than the hearing aid, not quite as loud and overwhelming, but I still hear a lot of background noise. I do hope this improves, but after speaking to several people, I understand that it may or it may not. I will also say that when I met with the surgeon, I had hoped to schedule the surgery at that time, but was unable to. We had to wait for insurance approval before I could do so, which came 2-3 weeks later. So, unless you already have approval, just be prepared when you meet the surgeon that you may have to wait for a short time before you can schedule the appointment. I got mine done at a popular center and was still able to get a surgery appointment just 2 months after finding out about insurance approval. I then had to wait 3 weeks to be activated. It's a long journey that I've just started, but so far I have no regrets! Best of luck!

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