CI candidacy....

Audiofuzzy

Audiofuzzy

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The basic criteria for CI are pretty simple - you must not be able to receive reasonable help from your HAs, and your hearing loss must qualify your for CI.

What Kinds of Hearing Losses are Treated with a Cochlear Implant?

The cochlear implant is designed for patients with sensorineural hearing loss that have failed conventional treatment including medications and hearing aids. Sensorineural hearing loss is a specific type of hearing loss, defined as any abnormality of the inner ear or auditory nerve that prevents transfer of electrical signals to the auditory nucleus (the brain's center for hearing).

Can Every Patient With Severe to Profound Sensorineural Hearing Loss Benefit from a Cochlear Implant?

Many people of all ages with many different kinds and patterns of hearing loss can qualify for cochlear implantation.

Unfortunately, not everyone can benefit from using a cochlear implant. Some forms of sensorineural hearing loss are a result of destruction of or absence of the auditory nerve fibers. Therefore, there is nothing for the cochlear implant to stimulate.


Everything is best explained here;
Cochlear Implant

DO OPEN this link and READ.


Since some people wondered about what I said about me first being declined CI and then saying I am hesistant to to get it because of my migraines - here's and explanation.

I was first interested in CI after seeying interview with Beverly Biderman on TV and after that, reading her book "Wired for Sound".

BTW - READ THIS BOOK!
you can order it here:
Amazon.com: Wired for Sound: A Journey Into Hearing: Books: Beverly Biderman

DO -READ -IT.

So at my request, I was reffered to dr Westerberg at the Vancouver hospital (or was it clinic, whatever) who upon seeying my audiograph (hearing test) said "I am borderline".
meaning my hearing loss was significant enough to qualify me for surgery BUT it was also important how well I do with my HAs.
It was determined my h.loss is severe but my communicative skills are too good to qualify me for CI.

I could have chose not stop back then, if I was TRULY determined about CI.
I could have challenge the decision, and I know deep down I would persuade dr Westerberg to go ahead with surgery anyway even though my communicative skills were good. Dr himself said it would be interesting to see how it would turn out, but the hospital must protect itself from eventual court processes would the surgery fail and I would complain.
But, for instance, I would have challenged the other test results as they were conducted in laboratory enviroment, completely unture of life situation.

But I wasn't so SURE I WANT the CI.

Don't forget, sensorineural loss is often progressive.
My certainly is progressive, and the hearing test I had done a year later already showed worsening of my hearing of about 10 db.
two or even three years have passed by now, and I can SEE I hear even worse that that.
I have no doubt have I applied for CI NOW I would not be rejected this time.

But at the same time, my migraine worsened, too, and now I have to take it under consideration while thinking of CI.
Because while deafness was never disabling me, MIGRAINE IS. I have disability pension because of my migraines.
So, for me, a lot is at stake- now I can hear with my HAs, and I know how they affect my migrane. I am sure I would be hearing even better with CI but I have no way of knowing how it will affect my migraine. Maybe I'll end up unable to use neither CI nor HA in th CI'ed ear, and I wouldn't like that.

Understand now, Liebling :)



Fuzzy
 
you must not be able to receive reasonable help from your HAs,
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But what's reasonable help? That's really the issue that I have with canidancy for CI. I realize that a lot of canidates are obvious right off the bat canidates, but in SOME (note I said SOME) cases, CI centers are doing the grey area thing.
 
deafdyke said:
But what's reasonable help? That's really the issue that I have with canidancy for CI. I realize that a lot of canidates are obvious right off the bat canidates, but in SOME (note I said SOME) cases, CI centers are doing the grey area thing.
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It depends on whether they are using other factors such as recruitment, tinnitus, presence of menieres, clarity distortion etc into the final decision.

For example some people at profound levels of deafness do better than people closer to the HOH end with hearing aids for a number of reasons that are not always understood.

This is why just about everyone, including babies and toddlers are expected to trial hearing aids and have speech tests with those hearing aids.

I prefer the present system of having guidelines e.g. as outlined by the FDA but taking individual factors into account.
 
yes, I am interested in your opinon what you think is "reasonable help". first, please?

Fuzzy
 
deafdyke said:
But what's reasonable help? That's really the issue that I have with canidancy for CI. I realize that a lot of canidates are obvious right off the bat canidates, but in SOME (note I said SOME) cases, CI centers are doing the grey area thing.
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The thing about the grey area, though, is that there can still be huge quality of life improvements. For example, when I went through the evaluation, I scored well within the candidacy range. I also did fairly poorly on the CNC test (16% in the ear that ended up being implanted). On the flip side, I was able to communicate relatively well, albeit with some effort, in spoken English. Like most people, I was able to compensate through lip reading and context. Some of my colleagues were surprised when they discovered that I had a hearing loss at all, so apparently I was passing in some situations.

So, by that measure, maybe I was in the grey area. But now, with my implant, there have been huge changes. I'm able to communicate in noisy environments that would've been hopeless before; it takes a lot less effort to carry on a conversation, so I'm less stressed and exhausted at the end of the day; I can hear phonemes that I haven't heard since I was a little kid.

So depending on which metric you went by - my performance in Real World Listening Situations versus my performance on the tests - whether or not I was a candidate might be considered by some to be 'grey area'. But the improvements I've seen just one month post-activation are huge, and I feel very confident that I made the right choice. Granted, not everyone is necessarily going to benefit, or do so this quickly. But being in that grey area of functioning doesn't necessarily mean that improvement isn't possible.

Which leads me to my point: what is it that makes you say a CI should be a last resort, or used only when absolutely necessary? Is it financial? Is it the surgical aspect? Is it the "being a cochlear success makes people think everyone should be implanted" argument? (Which, for the record, I think is ridiculous, but I've seen it argued.) In those cases, I think it largely comes down to a question of choice and autonomy. Still, I can't exactly figure out where this aversion to implants is coming from, unless you're uncomfortable with the idea of implants in general, but don't think you can argue for a more extreme position.
 
Using FDA guidelines, reasonable help from hearing aids would be when one can understand (with best fit hearing aids) more than 50% of sentences in the ear to be implanted and more than 60% of sentences with both ears.

The number of cases where someone who exceeds the criteria is implanted must be small because no insurance company is going to pay thousands of dollars if FDA guidelines are not met.
 
Well, I mean I guess what makes me uncomfortable is the fact that you can almost "shop around* at the different clinics. If one clinic turns you down, and you're VERY "grey area" (eg hear at the upper limits of where they'll consider implants) you can go to another clinic and get implanted.
I get the vibe that SOME of the grey area folks almost see the CI as the latest "gotta have" technology. Exactly like how ten years ago, everyone was raving about digital aids. End result was that not everyone likes digital aids.
But there were a lot of people out there who bought into the hype about digitals.
To an extent I see that happening with CI. I mean some of how they are pushing CI, really is almost marketing. I haven't seen it here (thank god!) Virtually EVERYONE here is very down to earth about CIs. However, I have seen it extremely hyped on Other Sites I Shall Not Name. I even got randomly IMd by some person who kept talking about how I should get a CI.
If criteria was more uniform, and if they were strict about making sure that grey area folks had exhausted other hearing technologies, I wouldn't even be speaking out. There's also the fact that response to hearing technolgies is VERY indivdual.
Oh and ismi, you're not nessarily a grey area case. You scored poorly. What I mean by "grey area" is more the person who scores at the upper end of the canidacy limits.
I definitly think that folks with severe recruitment and tintutas SHOULD get it without a huge hassle.
However, I do think with the huge cost of health care and the fact that this involves surgery, that doctors should be somewhat conservative about who they'll implant.
 
Well, I mean I guess what makes me uncomfortable is the fact that you can almost "shop around* at the different clinics. If one clinic turns you down, and you're VERY "grey area" (eg hear at the upper limits of where they'll consider implants) you can go to another clinic and get implanted.
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well... but you are still very close to the limits, aren't you? I guess if someone wants CI really bad then one won't give up, if fully convinced they really want it. Perhaps in the process the ones who are not so sure will give up?



I get the vibe that SOME of the grey area folks almost see the CI as the latest "gotta have" technology. Exactly like how ten years ago, everyone was raving about digital aids. End result was that not everyone likes digital aids.
But there were a lot of people out there who bought into the hype about digitals.
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Since CI requires surgery, I wouldn't compare it to digital Has so easily. But I know what you mean.
Also, if we go along these lines, then the CI hype should die down natural death after a while as well.

Fuzzy
 
I talked about migraines before. I had migraines so bad that I took three different medicines a day, 8 pills. I discussed this with my migraine doctor, he felt that the headaches might improve. Since surgery I have not had a migraine at all. I have had a few tension headahces, but no migraines. I am down from 8 pills a day to only one. I go to the neurologist on the 31st of October and we is going to check on what happen. That is just what happen with me. My doctors don't know of any research, but I'm still looking.
 
This is very important to me, Vallee, so yes I remembered that well. You give me hope :)


Fuzzy
 
I wouldn't compare it to digital Has so easily. But I know what you mean.
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Well I'm very glad that you see what I'm saying.
I hate how some people see me as a Sweetmind, simply b/c I'm a wee bit hesistant about implantation in ambigious cases. I'm more......."hey careful about the Newest Technology! New doesn't always mean "better"
I guess if someone wants CI really bad then one won't give up, if fully convinced they really want it.
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True, but while I think it should be easy for people who unambigiously qualify for CI, I think that there should be some sort of "hey have you tried ...... for the high ambigious canidates.
 
The only thing I wish about CIs is that they didnt involve surgery. I would like to try them but I dont want the commitment of goign thru surgery and having something put in my head. That's just me and my own comfort level.
 
deafdyke said:
But what's reasonable help? That's really the issue that I have with canidancy for CI. I realize that a lot of canidates are obvious right off the bat canidates, but in SOME (note I said SOME) cases, CI centers are doing the grey area thing.
Click to expand...

I love the gray area.

BTW fuzzy, I was the borderline canidate. I heard to well to qualify when in a nice quiet sound booth. But that's not life. :) Life is very noisy. (I really didn't realize HOW noisy LOL) I qualified after a HA adjustment, still passing the sentence part but didn't improve, but taking a noise test. I think I got the first sentence which was with very soft background noise but the next bump on background noise made it impossible for me to figure out which was the sentence I was supposed to hear. That got me the exception I needed (the gray area) I'm very happy with the results. I adjusted very quickly. And yes I did know the risks of losing the hearing in that ear. I excepted that I could make things worse. I LOVE the gray area. :) Cant say that enough.
 
jag said:
I love the gray area.

BTW fuzzy, I was the borderline canidate. I heard to well to qualify when in a nice quiet sound booth. But that's not life. :) Life is very noisy. (I really didn't realize HOW noisy LOL) I qualified after a HA adjustment, still passing the sentence part but didn't improve, but taking a noise test. I think I got the first sentence which was with very soft background noise but the next bump on background noise made it impossible for me to figure out which was the sentence I was supposed to hear. That got me the exception I needed (the gray area) I'm very happy with the results. I adjusted very quickly. And yes I did know the risks of losing the hearing in that ear. I excepted that I could make things worse. I LOVE the gray area. :) Cant say that enough.
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Apparently, they are developing a new speech hearing test to reflect real life situations. It sounds very interesting. New method for hearing loss assessment | Huliq
 
very good news R2D2 :thumb:

I have mild tinnitus and this make thing worse when I take a hearing test. sometimes I cannot tell if I hear the signals or tinnitus sounds. so I hope the new approach will produce better measurements and support.
 
jag said:
I love the gray area.

BTW fuzzy, I was the borderline canidate. I heard to well to qualify when in a nice quiet sound booth. But that's not life. :) Life is very noisy. (I really didn't realize HOW noisy LOL) I qualified after a HA adjustment, still passing the sentence part but didn't improve, but taking a noise test. I think I got the first sentence which was with very soft background noise but the next bump on background noise made it impossible for me to figure out which was the sentence I was supposed to hear. That got me the exception I needed (the gray area) I'm very happy with the results. I adjusted very quickly. And yes I did know the risks of losing the hearing in that ear. I excepted that I could make things worse. I LOVE the gray area. :) Cant say that enough.
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same here.. I'm in gray area,too. I do well if I listen to someone who is close to me and there is not noise. I have great difficulty in noisy environments such as cafes,restaurants,streets,crowded places,classroom,meetings etc..

I'm thinking of getting an implant when I can become a candidate in my country.
 
highlands said:
very good news R2D2 :thumb:

I have mild tinnitus and this make thing worse when I take a hearing test. sometimes I cannot tell if I hear the signals or tinnitus sounds. so I hope the new approach will produce better measurements and support.
Click to expand...

I would have horrendous bouts of tinnitus before my CI. Since then I have noticed that my tinnitus is barely audible with and without my CI on. I have heard of it making it worse but I thank my lucky stars that it has been relatively quiet.
 
Jag, I know how you feel about the grey area.....and a CI is AWESOME for those who have tried everything. I mean if there are severe and profound deaf people who get a lot of benifit from hearing aids, it makes sense that there'd be some more traditionally hoh folks who can't benifit from hearing aids. However, I really honestly think that for some grey area cases, it might be more effective for them to try different makes and models of HAs.
 
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