The Cochlear Implant Activation Process in Quebec

During a cochlear implant surgery, a computer chip in placed behind the ear, just under the skin. Electrode arrays attached to the chip, are threaded through the inner ear and into the cochlea. Then, the patient is left to heal for 3-6 weeks before being activated. During this time, they can’t hear through the implant because it’s not activated and they are not wearing the external hearing device. You can read about my surgery and how it went.

In Quebec, the activation process lasts 8-10 consecutive days. During this period, a lot of testing is done to ensure that CI is set up properly and that it is customized as closely as possible to match the CI wearer’s hearing. No two people have the exact same hearing, so everything is based on trial, error and response.

Day 1: Activation day
Before turning on the CI, each of the electrodes inserted – 22 in my case, but this may vary- is activated and the volume is set. They send beeps through each electrodes and set the volume for each electrode at the level which is most comfortable for you. The CI is then turned on without any programming done to it. Read about my activation day.

Day 2: Finding thresholds and volume
After having a whole day to just get used to sounds, CI set-up continues. Tests are made to find the lowest volume that you can hear at for each electrode. A neural response telemetry test is done to find the highest level of sounds that you can tolerate. This will allow the audiologist to create the proper mapping. You also learn about caring for the CI and how to use the humidity remover. Read about my day 2.

Day 3: Soft sound detection test and finding electricity speed
A soft sound detection test is performed in the audiology booth to determine your hearing level with the CI. Then, different programs at different electrical stimulation rates are added so that you can test which electricity speed is right for you. The mini remote is programmed, and you are taught how to use it. It makes things much easier. Read about my day 3.

Day 4: More electric speed testing
More programs at different electric speeds are added for testing. The advanced remote is programmed so that it’s even easier to switch programs and see what you are controlling.They then spend a good hour talking about cochlear implant safety and what you can and can’t do with the CI. I can no longer go on theme park rides that use magnetic pulling, and they even listed the ones that use this at the the La Ronde – Six Flags park in Montreal. CI users have to be careful in cases where the head can get wet and try to avoid static. I’ll write a full post on safety in the future. For now, read about my day 4.

Day 5 and 6: Audiology Exams and Electrode Peak testing
On day 5 you have your first word and sentence recognition tests. This is to determine which of the programs you hear best at out of all the programs with the different electricity speeds you can hear best with. Then once the best electricity speed is found, you start experimenting with the number of electrode peaks your CI should be programmed at. This test is continued and programmed at day 6. More audiology tests are performed to determine the amount of peaks you should be using. Read about my day 5 and 6.

Day 7: Programming the peaks
The amount of peaks is chosen and the CI is programmed with that. Different programs are are set, this time at the right electricity speed and with the correct amount of peaks. Over the next few days, you will test out the different programs. Some are best for noisy environments, some have features that can soften loud sounds or boost soft sounds.

Day 8: Final test and intro to accessories
One final soft sound detection test is performed to determine if you can still hear soft sounds. You then learn how to use all the accessories you chose, in my case, the mini mic, the phone clip, and the aqua kit. Read about my day 7 and 8.

Next: Rehab and mapping. After the initial programing, we immediately go through an 8 to 10 week rehab session. During this time, we have mapping sessions once a week, or once every two weeks.

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