Inside My Head

By Bob Liff

I am certainly not the only person whose realization that I suffered from an increasingly severe hearing loss came upon me gradually. My difficulty became noticeable when I was working as a newspaper reporter in the late 1990s. I could manage okay on the phone but had trouble following conversations in person if there was any ambient noise. Crowd situations were unbearable.

I also suffered from periodic tinnitus, which of course is utterly frustrating, but still did not attach it to having a chronic hearing loss.

I withdrew from social situations. I started making jokes: My wife says it’s not that I can’t hear, but that I won’t listen. Because my hearing loss is asymmetrical—much worse in my right ear than my left—I was losing my echolocation. I could not tell where a sound was coming from, and would spin around to find the source.

Eventually, reality kicked in. I went for a hearing test about 12 years ago and was shocked at the degree of the loss in my right ear—more than 50 percent in the midrange frequencies, less so in other ranges—and a slight loss in the left. 

My ENT and audiologist suspected Ménière’s disease, but could not come to a conclusion, which illustrated for me how much research still needs to be done to fully understand hearing and balance issues. I was fitted with a hearing aid for my right ear. Because of the nature of my hearing loss, I could not use an in-ear aid and had to use one that went over my right ear with an external microphone.

Both ears continued to deteriorate, the right more than the left. I could hear sounds in my right ear, but could not make out words. As it was explained to me, my auditory nerve was working normally, but the other parts of the ear where sound travels before reaching the nerve, especially the hair cells inside the cochlea, were not.

Bob Liff Cochlear Implant.jpg

My audiologist finally said there was not much more he could do for my right ear and suggested a cochlear implant (CI) on that side. I met with Ana Kim, M.D., at Columbia Presbyterian in New York City where I live, who performed the surgery.

One of the absurdities of the health insurance industry became apparent to me when I chose a CI that would be paired with a hearing aid for my left ear. While the hearing aid alone was not covered by my insurance plan, the far more costly CI in combination with the hearing aid was covered because the two devices were synched. 

The surgery was more extensive than I expected. Dr. Kim opened up my skull behind my right ear and burrowed out a bed in the dura on my cranium to insert the implant, which was then wired through my cochlea. I maintained my wise-guy attitude about the situation, posting a picture of my bandaged head on Facebook, explaining they had opened up my head and found nothing.

I had to wait three weeks for the effects of the surgery to subside before my new audiologist, Megan Kuhlmey, Au.D., also at Columbia Presbyterian, hooked me up for the first time—and nothing happened.

I was not the first patient who expected instant magic. It took several months before hearing began to return to my right ear. Each hearing test showed progress, though I did not feel it. The hearing aid in my left ear allowed me to compensate for deficiencies in my right ear, but eventually I began making out words in my right ear as well.

That is when I discovered one of the ways I had previously been coping with my hearing loss. While having morning coffee with my wife, she would have me cover my left ear; I was hearing things with my right. When she casually covered her mouth, I could no longer make out what she was saying. In that instant, I realized I had been reading lips for years without even realizing it.

Two years after the surgery, the CI has not yet restored full hearing in my right ear, though it certainly has improved it, and I no longer have problems figuring out which direction a sound is coming from. With the type of implant I have, I cannot have an MRI, since the magnetic force could tilt the device inside my head, and I get conflicting advice on whether I can go through a metal detector. Since the technology is always improving, if you are a candidate for a CI, discuss with your doctor which one best suits your needs and lifestyle.

As an aging baby boomer who just turned 70, I find lots of company in the hearing loss crowd. It is hard to generalize how hearing loss affects people individually, but I am surprised that for many, vanity remains an issue. For me, the prospect of improved hearing outweighs any concern that signs of the vagaries of age are visibly hanging on my ear lobes. 

I do wish I had tackled this earlier, and had not dismissed comments by well-meaning people saying I was not hearing them properly. And since I have also had surgery in recent years on my eyes, nose, and throat, I realize I have kind of a bionic head anyway.

What is inside my head is another matter.     

Bob Liff is a public relations professional in New York City.

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