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Should I get a cochlear implant? How to make the decision

Should I get a cochlear implant?
It has been 15 years since I received my cochlear implant. In that time, I have been asked by many audiologists if I would counsel some of their patients who are potential cochlear implant (CI) candidates.
Through the many conversations I have had over the years, I have learned how to help people answer the question, “should I get a cochlear implant?”

I want to fully clarify the type of advice that I have given.  Yes, I am a trained audiologist who also has a hearing loss.  However, I am not by any means an expert on Cochlear Implantation.  Instead, I consider myself a highly knowledgeable patient.  But, it is from the patient perspective that I am offering advice.  I strongly encourage all patients considering a CI to contact their local implant center in order to get the most up to date information about the benefits, risks, and alternative courses of treatment for their hearing loss.  In every conversation I have had, I make this point clear.

Is a cochlear implant right for me?

So, let me put on my CI patient hat and begin.  Let’s pretend that you, dear reader, are the person with hearing loss wondering whether a CI is right for you.  Here is what I recommend you do:

Make an appointment with a CI audiologist

I encourage you to do is to make an appointment with a CI audiologist.  Not only for the reasons stated above, but also because the candidacy requirements have changed over the years.  A basic premise for any health care practitioner, including an audiologist is to “do no harm.”  The CI team wants to make sure that your life will improve in some way after implantation. They do not want your ability to function and communicate to decrease. However, as CI’s continue to improve, the basic minimum level of improvement that can be expected from a CI has also changed. The information that was provided to me was based on devices from 15 years ago. There have been technological improvements since then and hence it is important to get the most current candidacy information.

For me, I was clearly at the end of my ability to function with conventional hearing aids. Even with the use of FM equipment (now called Roger systems), I could no longer communicate on the telephone. I needed to lipread in all my conversations, even in quiet. Communication in noise was utterly impossible, thus preventing me from going out for dinner and other social events. These restrictions were impacting all of my relationships and putting a strain on my marriage as well. Finally, the amount of effort needed to have even basic conversations were enormous. Communication was exhausting.

Has this been your experience as well?

Have you restricted your life due to your communication challenges?

What changes has your family made?

You should ask your friends and family these questions, as you may be surprised how much your hearing challenges are affected them as well.

Not qualified for a CI, but need extra hearing help?

Do you function well in quiet but not in noisy social settings? If that is the case, then you should consider trying a Roger system.  These wireless microphones and receivers can significantly improve your ability to function without the need for any surgery. However, if you already have a very significant hearing loss, then Roger microphones are probably not the answer at this time. A Roger system is still advisable – but after you get a CI.

Getting a CI

Cochlear implant surgery for me was uncomplicated. I recall counting backwards in three’s, and then the next thing I knew someone was tapping my cheek to wake me up. While I did spend one night in the hospital, many other patients only require day surgery. The surgery was on a Thursday, I took Friday off from work and by Monday I returned to my job.

Although I had no complications, I do have some CI friends who had dizziness and nausea for several days. This passed for them with no additional problems, but do contact your CI team if you are having any problems.

Read more: Cochlear implant surgery: Preparing yourself and your infant

Following the surgery, there is a one month waiting time needed to let everything heal.

On my “hook-up” day, I was actually quite disappointed. I had unrealistic expectations about what “CI Day 1” was going to be like. I cannot explain why I felt I was entitled to understand conversations right away. My friend who had lots of dizziness at first, actually was able to understand speech right away. For me it was nothing but chirps and beeps, similar to listening to R2D2 form Star Wars.

However, my ability to understand speech and the quality of sound consistently improved over 6 months. After a year, I was able to achieve about 94 percent single syllable word recognition in quiet without the need for lipreading.

Functionally, I could have conversations in quiet again without always having to face my talker. I could also use the phone again, and could have conversations without feeling exhausted.

“After a year, I was able to achieve about 94% single syllable word recognition in quiet without the need for lipreading.”

You may also achieve this level of performance… but then again you may not.  No one can guarantee your reaction to cochlear implants, but going back to my previous point, you need to discuss with the CI team what you can reasonably expect. Everything after that is gravy.

What about social situations and noise?

Here is where a Roger system comes back into play.  The combination of a CI and a Roger microphone is remarkable. I truly believe that if you want to achieve the highest possible levels of function, and be engaged again socially, you must also use a Roger system.

Yes, there are Bluetooth microphones that can also help and may be sufficient for your lifestyle. However, if you want to function better in groups, then Roger is a must.


Should you continue to use a hearing aid in your non-implanted ear?

First, discuss with your CI audiologist whether you should do so while getting acclimatized to the CI. There are different philosophies out there.  But for me, I do indeed use my hearing aid on the other side.

My goals for the hearing aid is not for speech perception. I cannot understand a thing with just my hearing aid on. But, it does make voices sound more natural and really improves music perception. (This will be a blog post for another day.)

Read more: Why I Decided to use a Phonak CROS with my cochlear implant

Grateful for my CI

Are you nervous about this cochlear implant surgery, or just the decision to get a cochlear implant? I don’t blame you. But remember, that you are in control at every step of the way. You can change your mind and withdraw your consent, right up to the point that the anesthesiologist is about to put you under for the surgery.

I have absolutely no regrets getting a CI. Instead of lamenting the fact that I have lost my hearing, I am grateful for this technology that has improved my life so much.


What are the most important factors in your decision to get a cochlear implant? Let us know in the comments!

Author Details
Peter Stelmacovich is a trained audiologist with over 25 years of experience. For the past 14 years he has held progressive leadership positions at Phonak Canada, first as the FM Product Manager and more recently as the Director of Power and Pediatric Sales for Canada. This current position involves managing the latest hearing aid technologies for children with hearing loss, as well as wireless technologies used in educational facilities. In addition, Peter also manages the product lines used by adult patients with severe to profound deafness. Peter recently completed a Master in Health Administration degree from the University of Toronto. His interests have expanded to include strategy, change management, marketing and patient engagement. As a cochlear implant recipient and hearing aid wearer himself, Peter blends his audiological and management training, sales experience, and personal patient experiences in his work. Peter has been consistently recruited to speak at both Canadian and International conferences to share this unique perspective