I spent Thursday in Nashville at the Vanderbilt Bill Wilkerson Center for my Cochlear Implant evaluation. It was a full day and included 3 hours with the audiologist, meeting the surgeon, and having both a CT Scan and a MRI.
My day started at 8am with the audiologist, Susan Amberg, Au.D., CCC-A. She is the coordinator of the adult cochlear implant program. In addition to talking about my hearing loss history and answering some questionnaires about the ringing in my ears (tinnitus) and my expectations from a cochlear implant, we went through a number of hearing tests. Most people know about the “beep test”. You press the button when you hear the beep. She also tested my hearing aids to make sure they were functioning as expected. Poorly functioning hearing aids could have resulted in being sent home to get them in proper working order. I can’t imagine anyone having hearing aids that function so poorly to result in a person qualifying as a CI candidate, but since it’s a step, I’m guessing it’s happened a time or two.
The longer part of the audiological evaluation involved testing with hearing aids on. It involves repeating recorded words and sentences spoke with both male and female voices at a loudness level that is common for everyday speech. The test is performed in each ear separately then with both ears at the same time. It is also performed both in silence and with background noise. This is the part that I absolutely flunked!! The score for my right ear was 5% and my left ear was only 1%!
Most insurance companies consider a person to meet medical necessity criteria with a score of 40% or less on sentence recognition tests “in the best aided listening situations”. That means, if you wear hearing aids and you underwent sentence testing wearing them, provided that they were working properly, you were in your “best aided listening situation”. One of my walk aways Thursday was that I could have qualified much sooner, but I’m not spending time looking in the rear-view mirror.
Once the actual hearing tests were finished and Susan told me that I qualified for a CI, she spent time answering all the questions I had before moving on to giving me a very thorough overview of the 3 different cochlear implants available in the US. She had samples of the actual internal implants, the external processors, and lots of the associated accessories. There’s a lot to consider!! I’ll devote another post to my decision.
The next appointment was to meet the surgeon, George Wanna, MD. The majority of that appointment involved explaining the surgery and answering my questions. He already had the results from my earlier appointment with Susan and knew I “flunked”. One of my primary questions was about having 2 cochlear implants. Could it or should it happen at the same time, or if not, when? My hearing in both ears clearly qualifies for the procedure and once I set out on this path, I knew that I wouldn’t stop with just one CI. I learned that doing both at once is an option, but not one that he recommends. He shared 2 main reasons. First, doing one at a time would allow me to have “some” hearing in the non-surgical ear while the surgical ear was healing and during the time until activation. That seemed reasonable. Second, the surgical site is going to be sore for a while. Having both sides of my head sore at the same time would make it very difficult to be comfortable for quite a while. That was very practical.
Before leaving the surgeon’s office, I received the first of 2 immunizations, Prevnar 13. People with cochlear implants are at a higher risk of developing meningitis. This vaccine protects against Streptococcus pneumoniae, a bacteria that can cause both pneumonia and meningitis. I’ll get the other one in 8 weeks. It’s the Pneumovax 23.
My last stop before being able to head home was radiology. I had an appointment for both a CT scan and an MRI. I’ll go on record as saying I’m not a huge fan of going into the MRI machine. I was very tired and kept my eyes closed the entire time. I’m not claustrophobic, but that little tunnel they put you in is a little too close for me. I wasn’t sure why I’d need both a CT scan and an MRI. What I found out was that they are used to find any contraindications for CI surgery, and help in determining the approach for the surgery and can be used as a guide during the surgery.
The next steps are to get the CT and MRI results back. As long as they are “normal”, they will proceed with getting insurance approval for the procedure and once that happens, I’ll be contacted by the surgery scheduler to get a surgery date. I’m so excited!