One dear friend, a few days ahead of my cochlear implant surgery, sent me a message that made me smile: “I hope you bounce back from the unpleasant surgery bit really quickly, and get on with the “changed your life bit” ASAP!” Well, I’ve done the first part and I’m now contemplating the second, with my implant switch-on happening in five days’ time.
As I said in my last blog, kind people, enthusiastic and hopeful for me, ask if I’m excited. And I feel a bit like old Scrooge, with his “Bah, Humbug” about Christmas, as I reply in terms of cautious optimism and months of hard work ahead. The key, I feel, to managing the next phase of this journey is to have not great expectations but appropriate ones.
Lessons in disappointment
Unrealistic expectations are surely to blame for many of life’s disappointments. Take my daughter’s disappointment that she wasn’t fluent in German at the end of her GCSE course; that was never going to happen! (In fact, at the end of two years she could talk about recycling and knew the German word for narwhal, but would struggle to order a coffee; that’s a disappointing curriculum for you.) Of course the biggest gaps between expectation and reality are often experienced when we’re children. In old age, my Nan still recalled a Christmas party she went to as a child, where it was made known that one of them would receive a lovely doll that was displayed on the Christmas tree. It went to the child of the house, and the sugar mouse Nan went home with could not sweeten the taste of disappointment after her high hopes of possessing that doll.
At another party almost a century on, Pass the Parcel was a lesson in expectation and disappointment for my younger daughter, as you can see here as she watches her sister unwrap the prize!
A healthy dose of realism
I am grateful that every hearing professional I’ve talked to about having a cochlear implant has been helpful in setting realistic expectations of what hearing rehabilitation entails and what the outcomes might be for me, and has acknowledged the uncertainties. We know that people at my level of hearing loss and worse are likely to benefit from an implant, but I’m going to have to be patient and discover for myself just how that is going to pan out for me. The best I can expect, thinks my surgeon, is that I may be able to hear on the phone. That’s a great prospect! But while that might be a long-term goal, I’m sure there will be many small discoveries along the way.
Here are the headlines of what I understand about the way ahead:
Switch-on day may bring some immediate benefits but it might not
Despite my cautious, rational approach to the day the implant is activated, I may find that I have an affinity with Esther Summerson from Bleak House, who said “The beating of my heart was so violent and wild that I felt as if my life were breaking from me.” Indeed the experience of having the implant activated is very emotional for many people. I wonder, but don’t know, if the experience is more often dramatic for those with long-term, profound deafness than people like me, who have lost hearing gradually over many years and hear quite a bit with their hearing aids. I may be wrong, and perhaps I’ll be writing excitedly about how I heard a grasshopper cough, or something. But I’m not expecting fireworks, an orchestra, or any level of drama with my switch-on. I’m curious about what it will be like but keeping my expectations very low.
Outcomes with a cochlear implant vary between individuals
Doesn’t everything? This shouldn’t surprise us. I gather that electrode placement influences the success of the implant – and surgeon skill is rather vital here… Also, I’m working on the assumption that being diligent in tackling the work of hearing rehabilitation will give the best chance of having good outcomes.
It takes practice, patience and perseverance
I read a helpful article, Practice, Patience and Perseverance: Getting a CI is only the Beginning, in which the author describes her experience of the work needed to learn to hear with an implant. She likens it to getting a knee implant – you don’t run a marathon right afterwards, but with lots of practice you can walk normally. So it is with hearing; switch-on marks the beginning of a long period of rehab. I have been scheduled to have my first session of Auditory Training straight after my switch-on appointment, with seven more sessions expected over the next year – but daily practice for… well, months I think. My brain has to adjust to this new thing, to hearing in a new way. There are also six appointments for tuning the implant over the first year.
Understanding speech is the chief focus of rehabilitation
Indeed this is my top priority. Increasing difficulty with understanding speech has been such a loss for me and it’s impact would surely worsen with increasing age. Hurrah – note the use of ‘would’, not ‘will’, as I’ve every reason to hope (expect, even!) that implant technology will put this into reverse.
I have read that voices sound mechanical, a bit like Mickey Mouse, until the brain adjusts and normalises the sound. I confess I’m not looking forward to that. If you’re a hearing person, people’s voices are part of them aren’t they? Yet it’s not much good if I can’t understand what those voices are saying!
I’m curious to discover what will happen to my perception of accents. At the moment, it seems to help me if I’m lipreading to know what someone’s accent is. My brain must have made connections between accents and mouth shapes. But if I’m reading subtitles and not making much effort to hear what the person is saying, I might not pick up even a broad accent. I’ve just been told, after ten episodes of a programme, that one of the main characters has a strong Welsh accent – I had no idea!
People’s capacity to hear music with an implant seems to vary enormously and my expectations are pretty much zero. I’m just going to see what I get and be thankful for any gains. A very odd thing that has happened as I’ve lost hearing is that I struggle to recognise even very familiar tunes. Being told what it is can help, and if it’s something with repeated melodies my brain seems to ‘get it’ after a few repeats. It’s years since I could sing in tune and I’m not holding out much hope that I’ll regain that ability, nice as it would be.
There’s a lot of tech to get to grips with
I’ve read that the new kit one goes home with can be bewildering. Add to that, all the possible accessories, the apps, the online support, the auditory training sites, and it’s a technological challenge. I am giving myself a severe pep talk about embracing all this and getting on top of it.
Hard work and happiness
After all this realism and caution, it’s important to say that I anticipate gains in hearing that will bring me great joy (unless I can hear spiders…which would be appalling). Perhaps hearing is like happiness which, in Dickens’s view, “is a gift, and the trick is not to expect it, but to delight in it when it comes.”