I love a good debate and ive read many older threads about CIs in various forums. I am neutral to CIs and can equally see the pros and cons. I am going to be frank/blunt in my debate and nothing I say is meant to offend. I am not making choices for anyone here, only debating facts and logic.
1. Is it true many children who's parents decided on CIs grow up to resent this? How would the parents then determine if it's in the child's best interests or not? Is there a harm in waiting till the child is older?
2. From reading around, it appears that the CI satisfaction rate is 75%. Ive been told it's 95%. Could it be possible that the satisfaction rate has drastically increased in the last few years?
3. Im reading about implants being some elective surgery/procedure in order to have the "latest and greatest" or to "upgrade" from hearing aids. I feel that criteria for candidacy is getting too lax nowdays. Ive read a few recent stories of people only moderately HOH/deaf who somehow qualified for CIs either from the insurance or out of pocket by a surgeon willing to operate. They had a hearing loss of around 50db in some frequencies.
They will say that their speech perception is poor and that sounds are distorted with HAs. The thing im saying is CI is not a cure and not an instant fix. If they don't make the effort to train for speech comphrension with HAs, it won't be any different with CIs for the matter. As for distortion, since when is 2% distortion alot? The sounds I hear are very similar to the sounds my parents hear. I repeat a sound I hear and my parents say I repeated it correctly.
Even my audiologist says I can improve my speech if I wear my HAs more and train more. If he believes someone with hearing as bad as me can improve, surely someone with less severe/profound loss can do even better in less time!
Lip reading is a valuable option for understanding speech. I can understand 80% of what my parents say from lip reading alone without wearing HAs. Wearing HAs improves this a few % more. I sometimes don't wear HAs because I have little trouble understanding my parents and I guess im just lazy to open the box and insert my HAs.
Another thing that irks me is how they show the aided score with CI is better than with HA then I find out that they were NOT wearing the best HA and/or they had their HA programmed at significently less than the maximum potental! People will say that louder is not necessarily better. I might understand this if you had a corner audiogram and couldn't hear above 1000Hz. Missing so many higher frequencies will pose a challenge to speech comphrension, but there's always writing, lip reading and sign language(which I never needed to learn) I also do a pretty decent job pronouncing words and get lots of compliments for this.
4. How can louder not be better? Youd hear alot more faint sounds that you never heard before! Some people have the gain on their HAs down so far they barely even hear their own voice and talk too loud! I have this problem if I don't wear HAs! Take someone with normal hearing and stuff earplugs, he will complain that everything is too quiet. Why should it be any different for HOH people?
5. There's an ongoing debate on how much residual hearing a person can have before getting CI. I remember years ago you had to have none left to qualify for CIs, especially since CI would destroy your residual hearing anyway. Also CI technology was primitive and crude and inferior to HAs if HAs worked for you. CIs were seen as a last restort if no HA gave any aided hearing, your loss would be greater than what an audiometer could go as well.
As with my debate point #3, does anyone agree that the amount of residual hearing is the most important criteria? It's also the method that's least subjective, especially since you can use AB as a fool proof test, no worrying about a person not pushing the button when he actually hears a sound. I read someone say "don't push the button till the sound is loud enough to rattle your head then you will "pass" for a CI by failing the hearing test" doesn't this make you mad? That person is not only deluding himself but cheating himself and others out of lots of money! As for speech, he can simply pretend not to understand most words, how would they prove it?
Thus a person should have an average of 100db hearing loss(divide the numbers over 11 frequencies. A NR counts as 125db) and not better than 70db hearing at any frequency(125Hz to 8000Hz on the audiogram)
In your opinion, which of the following audiograms(found at Google images) would be a candidate for CI? Would any be considered borderline/ambigious due to the steeply sloping loss and corner audiogram? Which should definately not get a CI as the odds are not good enough of it being better than HAs? Ive done the math below, debate among yourself!
70, 75, 90, 100, 110, 125, 125, 125, 125, 125, 125/11=109db average.
55, 70, 100, 110, 120, 125, 125, 125, 125, 125, 125/11=110db average.
25, 60, 110, 125, 125, 125, 125, 125, 125, 125, 125/11=109db average.
55, 55, 75, 95, 110, 125, 125, 125, 125, 125, 125/11=104db average.
50, 55, 65, 70, 75, 90, 100, 110, 115, 125, 125/11=89db average.
My audiogram: 65, 70, 90, 105, 110, 110, 115, 115, 120, 125, 125/11=105db average.
6. The cost and risk must be mentioned. Someone said CI surgury is safer than most other surguries. Ill have to research this further, but we all know that no type of surgury is without numerous risks. Even the surgeons will present you a partial list of risks and have you sign an informed consent. This protects him from some liabilities and informs if you are sure you still wish to go ahead.
The costs are $50,000 and up, sometimes as high as $100,000 per CI. Double(or near) that cost for bilateral. For those of you who are uninsured or don't qualify for insurance funding, this is a huge amount of out of pocket expenses. There are people that can save up for a CI or to get a 2nd CI which is rarely funded by insurance. But many can't afford this or have more important things such as buying a house, car, food, clothes, college and paying taxes/bills. Even with insurance, you are paying for it every month plus typically at least 20% out of pocket expenses, $10k cost on a $50k CI. It's actually a shame more insurance companies don't fund hearing aids! I know people who go the CI route because of that reason alone! Not a good reason in itself. You can always buy used HAs for cheap, buy online or negotiate the price down.
7. Is it true that those who are post lingual, especially those late deafened are the ones who have the strongest desire for CI? It seems logical since us prelinguals have no idea what we are missing. We do wonder what high frequencies sound like, what it's like to hear near normal. But many of us are not terribly unhappy to be deaf and are content to lip read and hear environmental sounds. Those of us who are open to the idea of CI, how many of you are worried about not improving across all frequencies, especially low frequencies? If you have a HA aided score of better than 40db, especially if better than 30db, isn't that better than the average aided CI results? Also how much of an issue is the likley probability of losing your residual natural hearing?
Also how bad must your own hearing be to get a CI, in db HL? Do you consider your hearing bad enough, if not how much worse must it be? Isn't it logical that the worse your hearing is and the less benefit you get with HA, the better odds youll see a significent improvement with CI?
I have presented some valid points to my debate. You may present your own points as well as support or refute my points. I wanted to add that ive read deafdyke's posts and she shares the same views as I do. Like me, she remains neutral. I finished reading one of her posts about all the pressure there is to force a CI and that the parents think a child isn't normal if he's not hearing and that a CI would help the parents by making the child better hear/understand them. I also read that most hearing parents of a deaf child would get the child a CI but only 50% of deaf parents would get their deaf child a CI.