Head Trauma and Cochlear Implants

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rosecottage

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I am a 61 year old female, and I have always been hearing until a few years ago. I have Meniere's Disease, and am losing my hearing. My recent hearing test shows I am now a cochlear implant candidate. I have met with a doctor/surgeon for only a few minutes, he feels I will do better with the CI, hearing aids no longer work for me. I've had the MRI in preparation for cochlear implant surgery. I have an appointment with the audiologist and the surgeon on the same day in two weeks to discuss the results of the MRI and for the final evaluation and decision.

In brief, my health situation: I have chronic pain from arthritis and fibromyalgia. I use a cane and sometimes a walker. I've had 6 major surgeries since 2003 they were all female and hernia surgeries. I had a complete heart check last year....all looks fine, and I am not diabetic. No other health problems right now.....just the Meniere's Disease, arthritis, fibromyalgia and irritable bowel syndrome. I am VERY concerned about head trauma. I have had 3 concussions within 5 years from hitting my head hard on cement. I have had at least 8 falls within the past 5 years. Some of these have been on hardwood and laminate floors. I fell one week ago......I landed face first on hard cement and almost broke my nose. That was my worst fall yet. My husband has been a wonderful supporter for me, and he thinks I am worrying too much about damaging a cochlear implant, but I seriously have my doubts that a CI can hold up to my falls. Of course, all of this, and any other concerns will be brought up in that visit for the final evaluation. I am not sure what to expect.

I am asking.......would you get a CI if you were in my situation? My husband is a risk taker, he mountain bikes all the time and has had numerous falls, along with punctured lungs, but he merrily goes on ahead. I am not a risk taker. Any thoughts would be sincerely appreciated, and I thank you in advance.
 
My daughter has CIs and I talked to the surgeon about the risk of the implant moving or getting damaged because of a fall or her getting hit or something. He said the implant is sutured to the brain and is secure. He said she would have to hit the implant just right for it to dislodge and its very unlikely. I have no other advice than that. I would suggest talking to your doctor about your concerns and see what he thinks.
 
Tristen said:
My daughter has CIs and I talked to the surgeon about the risk of the implant moving or getting damaged because of a fall or her getting hit or something. He said the implant is sutured to the brain and is secure. He said she would have to hit the implant just right for it to dislodge and its very unlikely. I have no other advice than that. I would suggest talking to your doctor about your concerns and see what he thinks.
Click to expand...
It’s not sutured to the brain. It’s anchored to the skull. It sits between the scalp and the skull.
 
RC-
First it sounds to me that you feel events (doctors) may be rushing you into this decision. There is absolutely no rush. The surgeon still has 8 months to earn enough to buy Christmas presents for his/her kids.

I would put other concerns ahead of the one about head injury. I have suffered many concussions going back at least 35 years. I am presently 67, a bit older than you. my most severe head injury was in 2008 when I broke my neck and suffered a spinal cord injury being a happy risk-taker like your hubby. I also suffer intense digestive disorders although I have not sought a diagnosis. I have had clients and friends with fibromyalgia. It is a debilitating condition but arthritis can be as well. Some of those conditions may be linked to general inflammation, which can be aggravated by various foods and medications. There is so much to think about.

All operations require anesthetics and/or follow-on medication. We are not in control of what anesthetics get used, nor even what anesthesiologist we will have. "Oh gee, I'm a substitute!" My point is there is much for you to consider here and your present medical team may be focused solely on the hearing problem, as though treatment would not interact with your other conditions.

I suggest that your tendency to fall is by far the more serious problem in your life. Many docs and PTs seem to think that if a person gets a wheelchair that is the beginning of the end. I have heard dozens of stories from spinal cord injured people who have been strongly discouraged from using a chair even though frequent falls cause serious injury. It is a kind of superstition, as though no one could be trusted to get regular exercise once they own a wheelchair.

I use an exercise bike called a nustep as well as weightlifting machines at the gym 3 times/week. I am in decent physical condition, certainly much better than my guy, who walks with a cane but lacks the self-discipline for regular work-outs. While I can walk with a walker for limited distances if I walked for transportation I would have no life at all. My chair gets me safely through a moderately busy life, including getting back and forth to the gym. I stay safe. For me waling is a sport, not transport. Maybe consider using an ultralight manual chair? Falling does not have to happen.

I was told CI might be appropriate for me but decided against it. For me the learning curve would be steep, long, and frustrating. Being unable to function socially is also frustrating but a) it is unlikely the CI would fix that and certainly not quickly, and b) my brain and memory function are already degraded by multiple concussions, so see a). I have other priorities.

Again, there is absolutely no justification for anyone to rush you into a decision on this. Any elective surgery should be approached with the goal of the patient feeling confident in their choice and in their team. A team that pushes you for a decision? That tells me they do no have your best interests at the fore.

Maybe it is a great idea for you, and if it is you will come to think so in your own time.

I hope this helps.
 
Tetracyclone,

Thank you so much for your response to me........ it was like a warm hug and "I do understand where you are coming from." I have read what you have kindly written numerous times, and it has been extremely helpful to my husband and I. I really appreciate you taking the time to share some of your thought provoking wisdom with me. Thank you for giving us something to think about as we weigh out all of the pros and cons, and "should I or shouldn't I"?

By the way, I was allergic to the synthetic mesh that was used in a female surgery in 2005. I was one of the worst cases, it made me severely ill. That is when all of the chronic pain began and it has never left. I've always felt the mesh is what caused the fibromyalgia. I eat a healthy diet, am of normal weight, and am knowledgeable in herbs and homeopathic remedies. The chronic pain is better now than it was in the past. I went for months not being able to even lay down or lean back in a chair. I can now get around with a cane and walker, at one point I could barely walk, but I've made good strides.

My best to you......
 
Tristen, I knew it wasn't sutured to the brain :) I say funny things all the time. I have senior moments and senior brain. :rofl:
 
I was taken aback by the idea of it being sutured to the brain. Why not stitched? ;)
 
I go to the audiologist and surgeon next week, Friday the 13th. I am not sure what they will say, regarding my tendency to falling. I will let you know what they say, maybe it will help someone else on the forum, also.
 
Failure secondary to accident/trauma is one of the more common CI failures, though in the current models it isn't really "common." Med-El splits out their reliability by technical, technical+accident, then technical+accident+medical, and you can see that as of summer 2017, their synchrony implant after 3 years had ~1.5% rate of accident-related failures.

This is based on its 2.5 joule impact resistance rating, which is the same as the most recent Cochlear Americas implant. If you really wanted to be cautious, however, the Advanced Bionics HiRes 90k Advantage implant has a 6.0 joule impact resistance, which puts in ~2.4x more shock resistant that either of the other 2 devices. The HiRes Ultra has resistance that exceeds 2.5 joules, but I haven't been able to find a specific number for it. Looks to me like they shaved the weight down and added increased MRI strength support (1.5 with magnet in, 3.0 with magnet out) at the expense of some impact resistance, but unclear how much...
 
misterblacktx.....thank you for the above information! I wasn't familiar with the term "joule impact resistance," so you have been very helpful to me, I will do a bit of research on that.
 
rosecottage said:
I go to the audiologist and surgeon next week, Friday the 13th. I am not sure what they will say, regarding my tendency to falling. I will let you know what they say, maybe it will help someone else on the forum, also.
Click to expand...
What is news from your appointment?
 
rosecottage said:
I am a 61 year old female, and I have always been hearing until a few years ago. I have Meniere's Disease, and am losing my hearing. My recent hearing test shows I am now a cochlear implant candidate. I have met with a doctor/surgeon for only a few minutes, he feels I will do better with the CI, hearing aids no longer work for me. I've had the MRI in preparation for cochlear implant surgery. I have an appointment with the audiologist and the surgeon on the same day in two weeks to discuss the results of the MRI and for the final evaluation and decision.

In brief, my health situation: I have chronic pain from arthritis and fibromyalgia. I use a cane and sometimes a walker. I've had 6 major surgeries since 2003 they were all female and hernia surgeries. I had a complete heart check last year....all looks fine, and I am not diabetic. No other health problems right now.....just the Meniere's Disease, arthritis, fibromyalgia and irritable bowel syndrome. I am VERY concerned about head trauma. I have had 3 concussions within 5 years from hitting my head hard on cement. I have had at least 8 falls within the past 5 years. Some of these have been on hardwood and laminate floors. I fell one week ago......I landed face first on hard cement and almost broke my nose. That was my worst fall yet. My husband has been a wonderful supporter for me, and he thinks I am worrying too much about damaging a cochlear implant, but I seriously have my doubts that a CI can hold up to my falls. Of course, all of this, and any other concerns will be brought up in that visit for the final evaluation. I am not sure what to expect.

I am asking.......would you get a CI if you were in my situation? My husband is a risk taker, he mountain bikes all the time and has had numerous falls, along with punctured lungs, but he merrily goes on ahead. I am not a risk taker. Any thoughts would be sincerely appreciated, and I thank you in advance.
Click to expand...
 
Most definitely go through the surgery. I had a traumatic brain injury 4 years ago, which required major surgery. Although I was implanted 22 years ago, it did not harm my Cochlear Implant.
 
I just responded to a post about my situation. Had a traumatic brain injury 4 years ago, which was a life-or-death situation, and involved removing one side of my skull to relieve pressure on the brain. I did not have to have CI replaced
 
Thank you all for your kindness and your notes to me - I do appreciate them! I have read all the links given to me! I have been busy with family this week and have not turned the computer on in a few days, so I am slow in responding.....

I am getting the cochlear implant. My husband called Blue Cross on Friday, the surgery has been submitted, it is in pending stage. We are to allow 15 calendar days for approval. After that.....pre-op appointment and the surgery. I will be getting the Cochlear Nucleus 7. On Friday 13th, when my husband and I went to talk to the surgeon and the audiologist, a peace came over me, I knew then that I really wanted the CI, and I've had that peace since then. As for the falls, both told me not to worry about damaging the CI, I was at greater risk of breaking a bone. They also told me that quite possibly my balance will improve when I can hear again. I have found some great exercises on the internet for balance, and I am doing those in preparation of the CI, and I am noticing a difference in my stability. My husband has installed grab bars for me outside, and has built me easier places to get in and out of the house. And I purchased a quad cane (4 prong) to use instead of a single cane when needed. I also have a walker to use outside. We are doing everything we can think of to prevent me from falling.

The desire to investigate a CI began about last September for me. So I went to my audiologist in November, and got my first appointment with the surgeon this year, in early January. I've done much research on CI's. It has been an up and down emotional time for me. A time of a lot of anxiety.
But at my last appointment with the surgeon on Friday 13th, I finally realized 100% that I really wanted the CI and was willing to take the risks that go along with the surgery.

I will let you all know the surgery date soon! Thank you, again, for the help and support.
 
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