A good appointment...or is the verdict still in the air?

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Phi4Sius

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Was this a good appointment or am I facing a MAJOR uphill battle here?

Well, today at 10:00 a.m. was my initial consultation with the doc at the Head and Neck Surgery center for a Cochlear Implant. It wasn't the actual evaluation, which the doctor I met with initially didn't tell me. We were discussing Cochlear Implants as a solution to my being deaf in my left ear, he scheduled me for Head and Neck surgery, and I thought that would be my CI evaluation. I've heard of evaluations taking about a day (MRI, CT Scan, Vaccinations against Meningitis and other diseases that could be transmitted via surgery, etc.), so that's kind of what I was expecting (erroneously it seems). I realize that they could take longer. Anyhow, instead I met with a doctor that didn't seem to be a surgeon, but a general practitioner that works IN Head and Neck Surgery. And, there's no listing of the doctor on the Kaiser web site. Not entirely comfortable with that.

Okay, so I'm being given all the reasons NOT to go with a cochlear implant:

1. It will be an uphill battle with the insurance company. Apparently their qualifications for cochlear implant candidates require that both ears have to be profoundly deaf. Really? So having "one ear" to hear out of is "good enough"?

2. There aren't enough clinical trials with research to determine that a cochlear implant will help me. How so? Then can you explain all of the cases that I've seen of people regaining really good hearing (up to 15 dB and above) with the cochlear implant? Yes, I realize that it will take some effort of rehabilitation in order to hear normally. And, especially with my left ear having no hearing for 25 years, the Doc believes that it will take a long time for me to regain hearing matching the levels of my right ear. I realize that - I've DONE the research. I'm willing to actually DO whatever it takes to get my left ear to hear like my right ear. I realize it may, more than likely, take quite awhile.

3. Tried to tell me about the other options, such as the BAHA (Bone Anchored Hearing Aid) which is a metal conductor that's surgically implanted in the bone, with an external (very heavy, large, and cumbersome, it looks like) processor that conducts sound into the right ear, giving a "virtual" bilateral hearing experience. Well, ummm...sorry, but I don't want virtual Doc. I want the real thing.

So, I do have an appointment with their audiologist (I have to re-do a hearing test which I just had 2.5 weeks ago with that audiologist to verify my hearing loss, and discuss further options). So, it appears that after THAT...sometime will be the additional evaluations (MRI, CT Scan, etc.) that will help further determine my candidacy.

EDIT: Oh, and she also said that she has no idea if this insurance company even does CIs. Ummm...excuse me...I can name at least 5-6 offices that perform Cochlear Implant surgery WITH the brand that I hope to get...Advanced Bionics. So, we'll see how this goes.

*siiiiiiiiiiiiiiiiiiiiiiiggggghhhhhh*
 
Tried to tell me about the other options, such as the BAHA (Bone Anchored Hearing Aid) which is a metal conductor that's surgically implanted in the bone, with an external (very heavy, large, and cumbersome, it looks like) processor that conducts sound into the right ear, giving a "virtual" bilateral hearing experience. Well, ummm...sorry, but I don't want virtual Doc. I want the real thing.
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Actually the BAHA itself is pretty small. Besides, even with the CI you'd be getting a virtual hearing experiance.
It's not hearing the way a hearing person hears. Actually, unless I'm mistaken, you CAN trial a BAHA....maybe you should try to look into that. I really do think that with the healthcare overhaul, and trying to reduce health care costs, private insurances are going to really start cracking down on who can or can't get it. Like I do think that right off the bat canidites will have no problems getting it, but people who get a lot of benifit from HA, or who have one deaf ear are going to be cracked down on.
 
Sounds like you met an ENT who then in turn put you for a referal? Have you got evidence of insurance stating that you'll be covered for CI.. take it to the next appt.

Repeat Audiology is normal, they probably is giving you hearing aid trials first. I know it's a pain but thats how it's done, I have done 3.

Is your other ear Severly/profoundly deaf (i could have looked in other posts) Is it progressive?? The doc may realise that having no hearing in one year for 25 years would take alot of time and training.... keep willing!! I have heard of moderate deaf person recieving CI in profound deaf ear and hearing is progressive.

I am sorry it's not what it turns out to be what you expected. (((hugs)))
 
I think the doctor you spoke with was just being realistic regarding CIs. I know it's discouraging though. As far as hearing tests are concerned, Charlotte is right about audis performing more than one. I had two hearing tests as well as an ABR. (a test where electrodes are placed on your forehead to determine how much residual hearing you have -- in my case, it was to find out whether I had auditory neuropathy given my premature birth history) In regards to a BAHA, if your loss is sensorineural (which I believe you said it was), this option won't work since it is designed for conductive losses.
 
overthepond - I've called my insurance company three times at different times during the day, with different people stating that my insurance will cover the costs of a CI + surgery if it's deemed medically necessary to help the hearing loss in my left ear. All amplification options have been exhausted. But I don't want a bone conduction device because it doesn't help you localize sound...all it does is transfer sound from one side to the other ear...same thing with a bi-cross (or whatever that is) hearing aid. Neither one will help you localize sound like a CI can it seems. That, and using a BAHA seems like an absolute waste of resources, time, and money considering the benefits that a CI could provide my left ear.

As far as my hearing loss...here it is again. LOL :)

Left ear unaided:

250 Hz 100 dB
500 Hz 107-ish dB
1000 Hz 115 dB
1500 Hz 120 dB
...and then nothing.

Here's what it looks like for my right ear unaided:

250 Hz 50dB
500 Hz 60 dB
1000 Hz 65 dB
2000 Hz 70 dB
3000 Hz 85 dB
4000 Hz 100 dB
...and then nothing above 4000 Hz
 
Hear Again - Yes, you're right. My hearing loss is sensorineural. It's discouraging, but it's not going to stop me. :cool2:
 
Phi4Sius said:
Hear Again - Yes, you're right. My hearing loss is sensorineural. It's discouraging, but it's not going to stop me. :cool2:
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Good. I'm glad! If I were you, I would follow-up with the hearing test and explain to the audi the difficulties you are having with hearing in everyday situations. Perhaps the doctor you spoke to was just being cautious in regards to CIs. When I spoke to my CI surgeon, he outlined all of the risks as well as warning me of the possibility that I may not do well considering the fact I had severe-profound hearing loss for 10 years prior. (It has been said that people who have had severe-profound or profound deafness for 10 years or more may take longer to adjust to the CI.)

Fortunately, that wasn't the case and I ended up doing quite well with my CIs.
In fact, my former CI audi said my progress was faster than most people who had my degree of loss. She also thinks that my total blindness may have played a positive role as well since I wasn't distracted by visual stimuli and could only rely on what I heard through my CI.

Let us know what happens at your hearing test, okay?
 
Phi4Sius said:
Okay, so I'm being given all the reasons NOT to go with a cochlear implant:

1. It will be an uphill battle with the insurance company. Apparently their qualifications for cochlear implant candidates require that both ears have to be profoundly deaf. Really? So having "one ear" to hear out of is "good enough"?
Click to expand...

You could try but insurance companies prefer to fund those who really need a CI and are profoundly deaf in *both* ears. You could always take out a medical loan(if you can get financing) or save up to pay out of pocket.


2. There aren't enough clinical trials with research to determine that a cochlear implant will help me. How so? Then can you explain all of the cases that I've seen of people regaining really good hearing (up to 15 dB and above) with the cochlear implant? Yes, I realize that it will take some effort of rehabilitation in order to hear normally. And, especially with my left ear having no hearing for 25 years, the Doc believes that it will take a long time for me to regain hearing matching the levels of my right ear. I realize that - I've DONE the research. I'm willing to actually DO whatever it takes to get my left ear to hear like my right ear. I realize it may, more than likely, take quite awhile.
Click to expand...

That one surprised me. It's true the latest CI is under clinical trials but you can get 16 electrode CI that's been FDA approved. If you want 128 electrodes, you could join a clinical trial if you qualify. Ive posted an article on 128 electrodes in another post. Even if it doesn't benefit so much for speech, its great in other aspects, especially music.

15db is very unusual, one poster did get there and she actually says it's too loud? :hmm: I thought CI doesn't amplify so how can it be too loud? Id be happy with 15db! Well why aren't you getting 15db aided with your HA? If there's enough gain, why not? :hmm: your doc is right, it's a long hard road for your left ear to match your right ear and even that isn't guaranteed. Why haven't you tried a HA for the left ear? I believe it's required you trial a HA for 3+ months before you will be a CI candidate.

So, I do have an appointment with their audiologist (I have to re-do a hearing test which I just had 2.5 weeks ago with that audiologist to verify my hearing loss, and discuss further options). So, it appears that after THAT...sometime will be the additional evaluations (MRI, CT Scan, etc.) that will help further determine my candidacy.
Click to expand...

Sounds like fun, let us know if results are the same as last time. Also ask to try the Phonak Naida V UP on your left ear. Some sound is better than none!


Hey friend, have you seen my reply to your other post:

http://www.alldeaf.com/hearing-aids...und-hearing-loss-hearing-aid-questions-6.html
 
Actually, a person must trial the lastest up-to-date hearing aids for 6 months before being considered a CI candidate.
 
But I don't want a bone conduction device because it doesn't help you localize sound...all it does is transfer sound from one side to the other ear...same thing with a bi-cross (or whatever that is) hearing aid. Neither one will help you localize sound like a CI can it seems. That, and using a BAHA seems like an absolute waste of resources, time, and money considering the benefits that a CI could provide my left ear.
Click to expand...
Actually Hear Again, they are using BAHA for cases of unilateral sensonerual deafness, if I recall correctly. It acts like a bi-cros aid.
I know you have your heart set on a CI, but why not at least trial the BAHA? You might find that the benifits from a BAHA are better then what you're thinking. You might get some localization abilty with the BAHA.
Some is better then none. I also kind of think that to get a CI simply for localization abilty is kind of overkill. Yes, you would have hearing in that ear....but it's a lot of cost for just localization of sound.....you see what I mean? You might have had a chance to get implanted back in the old days. (like the early 00's) but right now with our health care system a mess, and health care costs, unless you have a really suberb insurance, you prolly won't get the CI.
 
deafdyke said:
You might have had a chance to get implanted back in the old days. (like the early 00's) but right now with our health care system a mess, and health care costs, unless you have a really suberb insurance, you prolly won't get the CI.
Click to expand...

Actually DD, the criteria for implantation have been loosened since the early 2000s. Aside from that, CI audis and surgeons know what kind of information insurance companies require for approval, so that shouldn't be a problem for Phi.
 
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