What Does a Cochlear Implant Sound Like?

It has been almost 7 years since I received my Cochlear Implant.  However, it seems just like yesterday.  I can still remember every detail from the time of surgery, to my first activation, and all the steps along the way to the restoration of my hearing.

I was not always deaf.  I was born with normal hearing.  I did not have meningitis, nor do I have any family history of hearing loss.  The only thing notable thing in my clinical history was that I had a series of painful ear infections.  It is likely one of those infections that caused the damage to my inner ear.

I began using hearing aids at the age of 5.  Over time, my hearing continued to worsen.  By the time I was in high school, my hearing loss was moderate-severe.  In University, my loss was in the severe range.  Interestingly, I did not begin using an FM system until my third year of University.  I simply did not know such devices even existed. I wish I was made aware of FM systems earlier, as I suffered academically from not hearing well.  In high school with smaller class sizes, I was an Honour Role student.  But in first year University, my average dropped to 60% and my initial hopes for studying Medicine were dashed.

I vowed to ensure that all people with hearing loss become fully informed of all the hearing devices or other forms of help that are available.  I did not want to see others struggle needlessly from hearing loss.  Thus, I decided to pursue studying Audiology and make this my personal mission.

But back to my original story about my CI.  Even though my loss was now in the severe range, hearing aids and FM systems provided me with considerable assistance.  My word identification scores were still in the 70% range.  However, as I crossed the line into a profound loss of hearing, my ability to understand speech started to diminish considerably.  By the time I became a candidate for a Cochlear Implant, my word identification scores were 0% for my right ear and 10% for my left ear.  Phone use was virtually impossible.  I struggled to lipread every word.  It was exhausting to try to carry on a  conversation.

I received my Cochlear Implant from the excellent surgery and audiology team at Sunnybrook Hospital in Toronto.  The surgery process went without a hitch.  I was out of the hospital the next day, and took a only a few days off from work.

After a month of healing, I went for my initial programming session.  I thought that I would be well prepared for this appointment.  After all, I am a trained Audiologist.  I have counseled patients myself about not having unrealistic expectations, especially on the first day.  But I knew there were some patients who could hear speech even on the first day of activation.  I wanted to be one of those people.  I felt I was entitled to be one of those people.  I was wrong.

After the initial Mapping was done, I listened to speech for this first time.  And it sounded like…GARBAGE.  Specifically, it sounded like R2D2.  It was just all a bunch of beeps and chirps.  I drove home that day and decided a nice bottle of single malt Scotch was needed.  I was feeling every emotion from anger, to bewilderment, to sadness.

But to make a long story short, the changes that occur over the next 6 months were rapid.  After about 2 weeks, the implant started sounding like Sammy the Snake hissing sentences into my head.  That’s better than R2D2.  Then it changed to Alvin from the Chipmunks.  Next it started to sound like a young Jerry Lewis.  Now it sounds pretty normal, at least to me.

My word identification score started to rapidly improve.  I cannot recall all of my scores, but after about 6 months I was understanding about 70% of monosyllabic words in isolation and 100% of words in sentences.  After one year, my monosyllabic word identification score for words in quiet improved to 96%.  I was and continue to be completely blown away by this.  After all, I started hearing just beeps and chirps.

Given that I recall having much better hearing, I can describe the difference between hearing through a CI vs a hearing aid.  Basically, when I had enough hearing to benefit from a hearing aid, speech and music sounded full and rich.  But as my hearing loss progressed, all I heard from the hearing aid were low pitches.  Everyone sounded like they had mashed potatoes in their mouths.

The CI sounds very crisp and precise.  I hear all the high frequency fricatives (s, sh, f, th etc) quite well.  I have been told that my speech has improved immensely, although I never realized that my speech production was deteriorating with my progressive hearing loss.  In hindsight, it makes sense.

Music and hearing in noise remained problematic.  To help with hearing in noise, we can get the same improvements hearing aid users get from the use of Directional Microphones or FM systems.  I use both with my CI and it helps.

For me personally, the use of a hearing aid in my non-implanted ear has helped with music perception.  Without a hearing aid, I can barely hear any bass at all. Bass makes music sound full and rich.  On the other hand, the treble I get from the CI makes speech and music sound clear and crisp.  Thus the CI on its own is fine for speech, but makes music sound like it is coming out of a small radio rather than a big stereo.  The hearing aid on its own sounds pretty bad for any type of sound, speech or music.  Combined with the CI, it does not help with speech, but does give music a richer deeper sound.

For those of you considering a Cochlear Implant, my single best word of advice to you is be patient.  Do not expect miracles, especially on the first day.  The improvements will come as your brain relearns to makes sense of these electrical signals.

Please remember too, that everyone is unique.  While my experiences are not uncommon, your pace of improvements and the final levels you reach could be better or worse than me.

I am so glad I took the step of getting a Cochlear Implant and would do it all over again in a heartbeat.