What is Cochlear Implant Rehabilitation?
If you injure a leg and have to get surgery done, you can’t expect to be able to run right after it heals. If the surgery was an invasive one, you would need weeks of physio therapy before being comfortable walking before you can slowly attempt to job.
It’s the same thing for cochlear implants. Right after the surgery, you have to let it heal for 3-6 weeks before it’s activated. And right after activation, don’t hear perfectly well. In fact, things may sound as weird as these people describe.
Learning to hear with a CI requires a bit of getting used to, because the sound is different from natural hearing. For some, this may not even take long, especially if they already had a sense of sound before.Those who have had profound deafness need to start from 0 and learn how to recognize sounds. Imagine not knowing what a knock or a clap sounds like…let alone what sounds each letter of the alphabet makes.
As I mentioned in my previous post, right after activation, CI recipients go through 8 to 10 weeks of rehab and regular mapping sessions. That involved going to the rehabilitation centre three times a week – twice for rehab, and once for mapping.
Week 1: Goal Setting and Audiology
The first day, I met with the social worker who would be overseeing my rehabilitation program at Montreal’s Mackay Centre. We filled a lot of paperwork and talked about what my goals were. Some people feel like they need to learn how to use the accessories, some feel like they need to learn how to recognize sounds all over again, and some people, especially those who have never heard before, need to learn how to hear from 0. We went down a long list of goals and I didn’t really find anything that suited my goals on that list. Mine were simply to improve the quality of hearing. By the time I started rehab, two weeks after activation day, I heard and understood everything – things just sounded metallic. Some people actually sounded a bit like R2D2 and I had trouble understanding when people spoke if they were too far.
The second day, I met with the audiologist who would be doing my testing and mapping. We did several audiology tests so that she can see where I am at. The tests were very similar to the ones I did in Quebec City. I filled her in on what happened in Quebec City and what I received in my Cochlear kit.
The third day, we ended the week by looking at my mapping and doing some adjustments. We raised the threshold a bit, and brought the volume up.
When we raised the threshold, I could immediately hear people’s voices becoming a bit less robotic. But the volume was too loud! It was so uncomfortable that right after the weekend, I asked the audiologist to turn it down.
Week 2: Rehab
The following week, I started my rehab sessions with Kathleen, one of the centre’s educators. She wanted to see how well I was hearing and what kind of rehab I needed.
She set me up at a computer where she had already prepared some exercises. These exercises were like word computer games. During the first one, a voice read out two words and when I heard these words, I had to identify whether they were the same words or different words by clicking on the SAME or DIFFERENT button. A lot of them were one-syllable words, that sounded the same.
Cat — Bat said the computer. I clicked different.
House—House said the voice. I clicked same.
And so on. I ended up getting all 50 of them right.
I looked at Kathleen, who was taking notes. “Did you understand every single word?” She asked.
“Not every one,” I said. “For example I wasn’t sure if one of them was ball or mall, but since they sounded the same, I clicked same.”
Kathleen explained that this was normal, but usually at the first rehab session, a lot of people have problems with this. She wanted to try a harder exercise.
This time, the computer screen displayed two words and read out one of them. I had to click on the word that it read out.
I did a bit less well on that one because some words were very similar. When a recorded voice says something like “tease” and your options are “tease” and “keys” it’s hard to tell the difference, especially if your CI is being adjusted. But I still got over 90% of it right.
“Do you find that you had to guess sometimes?” asked Kathleen.
“Oh yes, for sure. Recordings make things less clear.”
She agreed and decided she was going to test me with her voice.
She reached for an article that she had printed out.
“I’m going to read this to you, but I will cover my face so you can’t lipread,” she said. “When I stop, just repeat the last word I said.”
So she read the article, which was about Bali (yay,a travel article!). Each time she stopped, I would repeat the last word I heard. To see if I guessing, she started stopping in the middle of sentences. I got most of them right again.
So two days later, Kathleen came up with exercises that were a bit harder. She set me up at the computer and had me open an account on The Listening Room. This website has many levels of exercises designed to develop speech and listening skills. Anyone can register and try these – give it a try if you’re curious. One of the exercises in the highest level requires you to watch short videos and answer questions about it after. It was pretty easy, except the ones that were bad quality.
The next day, I saw the audiologist again to report on how I was hearing. We did some more tests to see if my CI was still detecting the same low sounds, and then looked at the mapping. Since she lowered the volume and threshold, it was now a bit too low, and the voices were more robotic. So she played with the levels to try to remove the robotic sounds without raising it too much so that it’s too loud. In reality, it probably wasn’t even super loud. We would have to slowly inch up to it – my brain just needed time to get used to loudness again.
Next: Rehab and mapping week 3 and 4
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