7 cochlear implant pros and cons that will make you think
Many people assume that when you get a cochlear implant, you are “cured” of deafness. This is complete nonsense. It just doesn’t work that way. A deaf person receiving a cochlear implant remains a deaf person; they don’t miraculously become a hearing person. There are many cochlear implant pros and cons to consider before committing to the operation.
Being deaf is not an illness that needs to be cured. It’s true that cochlear implants (CIs) can help some severe or profoundly deaf individuals improve their way of communicating in the hearing world. However, not everyone has positive experiences; some deaf people actively protest the use of CIs.
Many people in the deaf community resent cochlear implants for the effect it has on the hearing people in their lives. When a deaf person gets a CI, and it works to a certain degree, their friends and family assume they can stop putting in the effort to effectively communicating with them, because you can hear now right?
It’s important that you understand how much work and dedication goes into effectively using a CI. You don’t simply flip a switch and boom you can hear. Also, it doesn’t work for everyone.
Having said that, a hearing person who suddenly becomes deafened after decades of normal hearing will have a different experience from someone who was born deaf. A CI candidate with a memory of sound, knowing what things are supposed to sound like, will make those connections more easily, and is likely to be more successful, more quickly, than a person who was born deaf with no memory of sound.
Tom was a hearing person and became a CI candidate when he suddenly lost his hearing as an adult. After getting his CI, he says;
I struggled with getting my sound processors to “create” that same sound as close as possible. I wanted my dog to bark again but not like a sick duck, and I wanted my wind chimes to tinkle instead of clack. And after eight months of program adjustments we (my AuD and me) were finally able to give me a new bionic hearing “normal”, what I’ve since called a facsimile of “normal” sound.
How does a normal cochlea work?
The ear is made up of three primary parts, the outer ear, the middle ear and the inner ear. The cochlea is the inner organ of the inner ear. It is a fluid-filled snail-like structure with tiny little hair cells which bend when the fluid is disrupted by sound waves.
Each tiny hair responds to a specific frequency or pitch. The bending of these hair cells sends electrical signals to the brain for interpretation, allowing us to understand what we’re hearing.
The human ear is truly magnificently designed. However, we were not all meant to experience its wonders in the same way.
Due to CIs being such a controversial subject, I’ll keep the focus of this article to cochlear implants for adults and the pros and cons associated with it.
What does the cochlear implant do?
Cochlear implants are surgically implanted electrical devices that allow people with a severe-to-profound hearing loss to process sound. Referred to as an auditory prosthesis it provides a sensation of hearing, and some implantees achieve near-to-normal speech understanding in quiet acoustic conditions.
The implant works by transforming sound into electrical stimulation. A microphone-like device, or sound processor, picks up external sounds and digitises it. These digital signals are then sent to a tiny wire, with many electrodes, which is implanted into your cochlea. Each electrode corresponds to a different signal frequency. Your brain then receives the signal through the auditory nerve.
The problem comes in when two electrodes stimulate the same neural population or overlapping neural populations, thus confusing the sounds, reducing your understanding of what you might have ‘heard’.
How well does the cochlear implant work?
A cochlear implant doesn’t work for everybody, and not everyone is a candidate to receive a CI.
The audiology team try to give candidates realistic expectations of how successful they will be with a CI, and they will only offer a CI if they think a candidate will benefit from having one. Of course, they can’t predict how well someone will do. Statistically most people will do relatively well, those who have been recently deafened tend to do better than those who were profoundly deaf all their lives. Recipients can push the envelope, as I did, by practising listening to a variety of sounds on a daily basis to get the best out of their CI.
Being born profoundly deaf, my audiologist said I should not expect to do as well as most recipients – I will always have to lip read. By focussing on Auditory Verbal Therapy, listening to music and audio books when I was working or doing housework, asking people what I was hearing, I improved well enough that I can sometimes use the telephone or have a conversation with someone in the next room. It really depends on how they talk and it’s still difficult for me. With my hearing aids, I had NO hope of being able to understand speech. With the CI, I had some hope, and with lots of practice, determination and patience, pushed it as far as I could. It’s like training for a marathon – you tend to get out what you put in. It’s important to remember that everyone is different and can get very different results at activation. The CI won’t cure your deafness, but it sure is a heck of a lot better than a hearing aid.
There are many factors that contribute to your CI outcome, including:
- The amount of residual hearing you have.
- How long you’ve been deaf for.
- Your age, overall health and other medical information.
- If you have a functioning auditory nerve.
- The type of device implanted.
- The experience of your surgeon.
- Postoperative complications.
Pros
Hearing
Increases your level of hearing, making it easier for you to communicate with your friends and family and follow conversations.
Speech perception
CI development has improved a lot, allowing recipients better speech perception in quiet environments.
Career
A CI can expand your career opportunities, setting potential employers concerns at ease.
Learning
Increased opportunities to learn and participate in a learning environment without outside assistance.
Safety
Being more alert to potential dangers, for example hearing sirens and thunder.
Music & telephone
Many recipients enjoy the beautiful melodies of music and even use the phone.
Confidence & independence
Many recipients experience a boost in confidence, being able to hold their own in a conversation.
Cons
Background noise
Background noises, like many people talking or environmental sounds, can affect a CI recipient’s understanding of speech. Technological advances are rapidly improving this.
Surgery
All surgery carries an element of risk.
Sport risks
You must be careful participating in certain physical activities, including high contact sports and water related activities.
Maintenance
A CI does require maintenance, for example replacing wires, changing batteries or remapping of the sound processor.
Side effects
It does take some time getting used to the CI device. It might irritate your skin, or you may experience muscle spasms, numbness and even facial paralysis. Fortunately this is rare.
Training
Sounds are translated via the device and might sound unnatural at first. You need extensive training to perceive and comprehend the sounds more effectively.
No guarantees
There is no guarantee that the implant will work well. You could lose any remaining or residual hearing.
The cochlear controversy
If you’re a hearing person reading this article, you might be surprised to find out that many deaf people don’t like CIs and believe them to be a threat to deaf culture.
The controversy about cochlear implants are primarily directed to the definition of deafness as a disability. Many deaf people argue that they should not be seen as disabled, but rather as members of a minority cultural group.
They do not see deafness as an illness to be cured or a problem to be solved. For them, being deaf is part of their identity and getting a CI would destroy their identity, effectively betraying their cultural values.
In my opinion, this is pure rubbish. I have two cochlear implants, and I am still deaf. What I mean is I still require communication support when dealing with noisy environments and multi-person conversations. I will never be able to be a fully hearing person, and that’s ok. I’ve accepted I am deaf – but now I really do have the luxury of selective hearing!
I understand that deaf people against CIs believe they’re fighting for the preservation of their culture, and that’s great, but change cannot be stopped, especially with technology. Every person should have a right to their decision and not have to defend it.
How much does a cochlear implant cost?
UK residents wanting a CI can usually get one on the NHS if over the age of 18, and two if younger than 18. Very few people in the UK need to pay for a cochlear implant. An adult might get a second CI if they are blind as well as deaf, or have another qualifying disability.
In the UK, the cost of assessments, surgery, and aftercare is around £20,000 to the NHS. The CI device costs upwards of £20,000. Paying privately for the CI will easily double the cost.
In the USA, the cost of a CI, including all add-ons, is around $150,000.
A cochlear implant will not give you ‘normal’ hearing, but it will enable you to hear better. When I say ‘hear better’ I’m comparing CIs to the standard hearing aid.
Today, cochlear implants are more sophisticated, and they help many more people with severe to profound hearing loss than ever before. Still, a CI cannot replace natural hearing. The cochlear implant pros and cons should be carefully weighed before you make your decision.
That being said, the decision to receive a cochlear implant, if you are eligible, is yours and yours alone. I encourage you to respect every adult’s decision and not judge them. The best impartial website to help you to make an informed decision is Cochlear Implant Help. There you will find a very useful comparison chart.
You can read my personal cochlear implant story and how I went from rejecting the very idea of having a “thing” implanted into my head, to acceptance and learning to live with a new way of hearing. Cochlear implants and hearing aids are so very different. I now understand why hearing people find it so hard to understand hearing loss, and why deaf people can’t really comprehend what it’s like to hear. It’s like night and day. I’ve lived through the shock of going from almost zero hearing to a full-on Take-Me-With-You-World rollercoaster ride at ninety miles an hour – and lived to tell the tale – and I’d do it all over again!
If you feel you need additional communication support after getting a CI, feel free to browse our range of services and find your perfect fit.
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Friend of mine who got CI and after being recovery and able to go back to work at office. All her co-workers all suddenly talk to her as they thought she can understood of everything they said. Good grief.
I had my manager say to me, when I explained I still can’t hear like a hearing person and need to lip read, he said “What’s the point in getting a CI?” – this was AFTER I had given them training. It is hard to get hearing people to understand that a CI doesn’t always mean we can automatically hear like they do.
I’ve been bilateral for 3.5 years and hear pretty well for a deaf old guy. While it can be frustrating explaining again and again that I don’t hear like a normal person, I have no regrets. CIs gave my my life back!
After 18 months with one cochlear implant, I’m considering having my second cochlear implant very soon, October. I will then be bilateral. However, the last mapping has given me such good sound for speech, that I’m now wondering if it is worth the surgical risks and expense of getting the second implants. Is having ‘stereo’ sound worth it?
Hi Linda, everyone I have spoken to has said it is worth having a second implant. In my case, I now feel like a hearing person, I don’t feel like I am wearing hearing devices. The surgical risk is very small. You can read about the benefits of being bilateral in my blog post: 1+1=3.
My son was implanted at 16 months and 2 1/2 and it was alot of work in the beginning ,but worth every moment.
I have been told the need to recharge the battery each night means taking it out to do this leaves the person totally deaf. I find thye idea frightening especially if I were to be on my own and unable to hear warnings , not that I hear smoke alarms currently. Is there a spare battery for recharging?
Hi Patricia, you can get a rechargeable battery. It is just like taking out hearing aids at night. You can install a smoke alarm that vibrates a pad under your pillow, and there is a similar pager system for sounds around the house which can connect to a pad under your pillow.
I have had the CI for a year now, they are still programming it in. I hear beeps, buzzes, hums and noises that sound like Morris Code! Surgeon questioned the Audiologist on why I cant hear people speak yet. Their response was: We are stimulating the inner ear. Are you kidding me! One year later and they are milking me and insurance company dry.
This is happening to a dear friend of mine. He is almost to the point of not trying anymore.
If you changed audiologist, did it help?
I would recommend to try a few and see what you feel that audiologist is there for your interest, not to pocket thier own money because CI is not cheap. A lot of doctor encourage CI because of hte money.
i think anything is better then none if it does not work at lest you have given it a go there is more to gain when first had hearing aids a car when past and could hear wind water running now am getting bad told cochlear implant next if you are hard of hearing people talk around you not to you never mind the bad looks plus i cannot sign so you are on your own think want you may hear next its more exciting to open your world more hear the birds plus music if not at lest i tried
I’m on my third and worst implant. I went almost completely deaf in December 2012. In the same week I found out I had breast cancer. They couldn’t do my implant until after my cancer surgery and treatment was over. That was the worst nine months of my life. I couldn’t understand anything anyone was saying all throughout my cancer treatment. The first implant went good but the doctor put it too low and over time it had slipped all the way behind my ear. When I told him about it he referred me to another doctor. He didn’t even look at it. I guess he didn’t want to do anything because of my insurance being Medicare and a supplement that paid for it but maybe not enough for him. Anyway the next doctor went in and moved it up higher but when I was in recovery he tested it and everything sounded distorted. I had to wait until the audiologist turned it on to see if it was still the same and it was. All distorted and couldn’t understand anything. They did a Ct scan and saw there was an electrode loose so back I go again but this time he had to put a whole new one in. They’re not aloud to use the same one three times. When they turned it on everyone sounded like Mickey Mouse which they said wasn’t uncommon and eventually it did get batter but not as good as the first one. The first one everyone sounded pretty normal. Then with the new one the rechargeable batteries started going dead before there time. They are supposed to last 20-30 hours. They were only lasting 7-8 hours so I contacted Cochlear and they sent new batteries but they didn’t work any better. They finally sent me a whole new unit but that didn’t help with the batteries either. I finally got in to see my audiologist and she said it was the program that was causing it and she changed it. Now the batteries last but the sound is terrible. Everything sounds like I’m going through a tunnel or kinda echoey. I don’t know if it’s the program or the implant that’s causing it. Sometimes the sound will go up and down in volume when I’m not touching my remote for it. It also hurts and itches a lot. I never had these problems with the first implant. If that doctor hadn’t been too lazy to put it up higher the first time I don’t think I would be writing this. If you are thinking about getting one which I do recommend make sure you ask a lot of questions about everything that they are going to do. Happy hearing
I’ve had the same problem. And it turns out that your program does effect you battery life. Now if u want more battery life u will have to lower your output at the cost of quality. If u want better quality u sacrifice battery life. It’s a trade off. For the quality option rechargeable batteries as well as throw away ones working in combination with each other can make your life easier. It’s expensive yes but you don’t really need your implant 24 hours a day . You can also get 4 rechargeable batteries(I say 4 because I am bilateral so 2 each device) which last me all day if I chose to wear it that long.
I am thinking about having the surgery. My hearing has gotten worse and I don’t understand what people are saying even if I hear their voice. My hearing aids are no longer helping me. I have lost most of my friends and can’t hear my grandchildren. I can’t get a job because I can’t hear. I use a caption phone only. Financially I’m struggling. So I need a job. My nephew, who is a doctor in a big Philadelphia hospital told a member of my family that it is the worse surgery. That I definitely should not do it. I’m waiting for him to call me to tell me why. Im a healthy 78 year woman who would like to go to Church, and take art lessons. Can’t do that now. I am now so torn as to what to do.
The worse surgery? With all respect, I would recommend speaking to a CI doctor who is an expert in these things and can give you the facts. It is usually very successful. The surgery is pain free and much safer now than it was decades ago, it’s very safe. The oldest person to have a CI was 98 or 99 years old. Do speak to a CI surgeon and audiologist before writing this option off.
I am 71 and had my first implant in 1996. Last month had that one replaced, since ithe internal components were no longer compatible with the current cochlear equipment. I am now in the process now of learning to hear again and I am and have been very happy that I hace my CI
I’m 67years have not regrets at all having the cochlear implant surgery. It is hard work in the first few months allowing your brain to make sense of the sounds. Now 18 months after the surgery I hear extremely well in quite challenging situations. I love having conversations with my grandchildren. I feel I have been released from a cage. A few days post op, I felt pretty good and in less than a week I could drive again. So for me the surgery wasn’t hard. If you are a suitable candidate for the implant, I say, go for it!
I am a candidate for a cochlear implant but I am terrified I am going to end up with vertigo and dizziness. To me there is nothing worse than being sick to my stomach and vomiting. I have read many, many articles on the pluses and negatives of the implants, so now I don’t know what to do! The surgeon who is doing the implant says it is nothing to worry about! Should I do it or not? I still have 18% hearing in the ear that will receive the implant and I am 71 years old.
Hi Rachel. The best people to speak to are your audiologist and surgeon. They can advise if you are likely to have vertigo and dizziness. Don’t worry about what you read on the internet as there is so much rubbish online as well as advice and personal opinions. Your CI team will know your medical history and will be able to give you the best and most accurate advice. Your surgeon has said don’t worry, so I would recommend you do exactly that! Congratulations and enjoy your new hearing.
Hi Rachel,
Just had the procedure last week. Temporary balance issues due to the inner ear now being filled with fluids, took a number of days to be completely sure-footed. Did not spin or get dizzy, just wandering like a drunk. A temporary nauseous feeling from fluids draining down Estacion Tubes to throat then to stomach, did not throw up just yucky feeling that did work out. Imagine getting teeth pulled and that drainage going down your throat into stomach, that feeling.
I am 18 months into my CI. The improvement is marginal. I can carry on individual or small group conversations. Noisy environments, telephone and television are not much better than before. The mini-mic is not much help. The phone interface is a little better, but it depends on the caller. Music unrecognizable. Sound is similar to a small speaker that is being over driven, very distorted.
Is it better than before, yes, but only half off what I hoped for and was ked to believe.
Hubby had transplant 16 months ago. Has never heard anything. After transplant, equilibration is so bad he has to use a cane. No sense of taste. has lost about 40 pounds. A few days ago Surgeon has decided unit is faulty and has ask if he would want to do another transplant. Monday July 9, 2018 I called the Surgeons coordinator and she is to call with a surgery date. We don’t know what to expect from this surgery. We are in hopes he will be able to hear and hopefully his other problems will be taken care of.
I’m currently on my second processor am a recipient for over 17 years now however my second processor was now damaged and needing another processor. Problem is insurance company doesn’t cover and wanting to charge me $750!!! Why do we even have health insurance policies??!! They said it’s not medically necessary. I’m only 33 without my CI I am completely deaf and therefore can not do my job!!!
Contact your CI company and audiologist, and ask them to help you fight this.
I’ve been deaf for about 16 years. Medicaid or Medicare should cover a lot of that cost and you should be elgible because being deaf is still considered a disability. You really need to look into receiving those benefits.
I had mine 2005 being partially deaf since infancy. Wore it 2 years before I took it off permantly. I was 55. Noises bothered me, dripping faucet, lights buzzing, cars on the highways zooming, startling noises everywhere but come to find out that speeches required work when I don’t know what I am loo,ing for as to find the right tone. I live in a rural area where I would have to drive 300 miles round trip. I prefer my hearing aid.
The cochlear implant is a lot of rehabilitation work. I love my silent days when I don’t wear mine and have no tinnitus. It feels like sensory overload sometimes. By persevering and wearing it all the time, with lots of programming tweaks, you do get used to all the sounds and it starts to sound and feel normal.
I can hear with one ear using hearing aid, my question is: Is it worth to get the risk of getting a CI in the other ear which is actually about 50% good?… what do you think???… need your opinion as I have the surgery on 21st. of this month of Sep./2018 (in 10 days only)
The cochlear implant team would only offer you a cochlear implant if they think it’s worth it, that you would benefit more from a CI than from a hearing aid. So, don’t worry – just be prepared to put plenty of rehabilitation work in to get the most out of it so it’s giving you the maximum benefit. It’s far superior to a hearing aid. You should be able to tell your audiologist any worries so they can reassure you.
I am 67, I have severe high frequency hearing loss. All of my middle and low frequency areas are fine. I have Resound programmable aids which my audiologist says are maxxed out for picking up the high frequency ranges of sound. My problem is like all high fq hearing loss people – I can hear the sound of conversations but have a hard time making out the words from people with higher freq speech. My wife is pushing hard for me to get a CI because she’s tired of my asking her to repeat herself. She also wants it because then she believes it will do away with a reason I avoid gatherings of more than 4 people. I am very apprehensive about the post implant rehab and the poor sound quality I hear so many CI people talk about when they are turned on – we also live in a mountain community so I anticipate the procedure and all post procedure work would require travel. OK< my question is – should a person with only high freq hearing loss have a CI ?
Hi Tom, a CI will give you a range of frequencies, it really depends on how much workable hearing you have left, not which frequencies. Your audiologist is the best person to speak to on whether a CI will suit you or not, and whether they will admit you for speech perception tests which calculate whether you’d qualify for CI or not.
Due to working in an extremely loud machine factory environment I acquired tinnitus in my twenties. I didn’t realize how much I had lost until I was in my 50’s and started wearing hearing aids. When I was 67 I experienced a total hearing loss in my right ear. I was given cross over hearing aids to take the sound coming from my right and send it to my left ear. It is extremely frustrating trying to communicate with people and I still have to turn my head to get some idea what they are saying and I usually get it wrong. I am thinking about getting a CI this coming Spring. I wanted to know if you have to be careful around microwaves and other electronic equipment.?
Good luck with your hearing journey. The CI does come with a few warnings – electrosurgery, diathermy and electroconvulsive therapy. Your hearing specialist or a cochlear implant company can tell you more.
I am in the process of getting evaluated for prospect of CIs I currently use hearing aids but in large table settings such as on a ship it is mostly impossible to follow conversations. on the telephone I am guessing in many instances of the conversation so thank God for texting.Can the receiver on the outside be taken off easily or maybe it cant be disconnected. Does CI improve those instances. I am also finding it more and more difficult to have a one on one conversation.
You remove the processor (the external part) just like your hearing aid. Everybody’s experience is individual but most will do much better than they had with hearing aids, however not everyone will achieve hearing like a hearing person’s. Much depends on the individual’s medical history, the success of the surgery, good CI programming, good rehabilitation and frequent mappings.
Im 59 and became deaf a couple yeas ago. Im thinking about having the implant, but my problem has not been that i cant hear, ive got some crazy things playing in my head, all kind of radio stations and whispers, and strange noises, i have something called mystery nusical ear and its driving me skitzo. Im serious im hating life because of it, these sound do not come from my ear, they sre coming from inside my head. And this sucks.
This is tinnitus. It’s best managed – the general advice is to be careful with your diet (no salt, less coffee etc) and reduce your stress levels.
my mom had the implant done a few years ago and about 7 months ago started having pains shooting through her leg and also hearing loud roaring noises like a motorcycle. She has been to several doctors and one said it could be nerve damage from the ci. Has anyone else experienced any of these problems?