Cochlear Implants Questions

[davidlawson]

I know that some of these questions are probably outside of your experience because they are to do with the UK healthcare system and this seems to be mainly an American website. With that caveat...here goes:

My situation:

I was diagnosed with hearing impairment when I was 3. My hearing deteriorated until I was 6, where it has plateaued at profound Deafness. I have worn hearing aids since I was 3. I can sign BSL, I can lipread (speech read) and I’m a fluent oral speaker (I rely mostly on lipreading though- I cannot understand a conversation, for instance, if I’m not lipreading). I’m now 21 and am weighing up the pros and cons of getting a cochlear implant, and I live in the UK.

I’m particularly interested in the experiences of people who had a cochlear implant who were in a similar situation to me - i.e. They could communicate hear before the cochlear implant but not as well as a typical person, and there has been a notable delay between their deafness and getting a cochlear implant.

I don’t think that the experience of those who got a cochlear implant when very young, or after having normal hearing but became Deaf when they were an adult will help me much in making my decision to get a cochlear implant.

Here’s a list of questions that I have. It’s quite a list but if you could answer any of them I would really appreciate it.

Questions anyone can answer:

Is it worth waiting for future technology?
Do the current CI destroy the existing cochlear hairs? If it doesn’t is the process theoretically reversible? E.g. Go from a CI back to a hearing aid?
What are the present guidelines in the NHS re unilateral/bilateral CI, e.g. Could I get bilateral CI or is unilateral CI the best I could get?
How long do the CI last typically? I have heard the figure 70 years being bandied about.
What are the risks of the operation? What percentage of cochlear implantees have complications like the body rejecting the CI, losing your taste etc?
What are the best CI? What CI do the NHS provide? Which CI have the largest market penetration in the UK?

Questions for anybody who has had a CI:

Did you get unilateral/bilateral CI? What difference do you think it makes? Did you get your unilateral CI in your best or worse ear? Why? Is it reasonable to think that my best ear would have the best results for a CI? What’s it like wearing a CI with a hearing aid?
What activities are curtailed? What sports should I avoid? I heard somewhere that CI don’t weaken the skull so there’s no additional skull strength issues to consider. Is this true?
How do you cope with living with a CI? Do you cover up the CI? What precautions do you take?

Questions specifically for people in a similar situation to me:

Were you able to use the telephone after getting the CI? Could you do that before? (I can’t do it now, but if a CI could give me that ability then it would be a massive plus for me.)
How did the range/sound distinction/amplification improve?
How long was the rehabilitation process?
Could you listen to/appreciate music? (I can listen to a very small amount of music and would love to be able to hear much more than I can do now).

 

[overthepond]

Whoa David, thats alot of questions!! LOL, I am from UK.... I will answer the questions as i can.

 

[overthepond]

i know that some of these questions are probably outside of your experience because they are to do with the uk healthcare system and this seems to be mainly an american website. With that caveat...here goes:

My situation:

I was diagnosed with hearing impairment when i was 3. My hearing deteriorated until i was 6, where it has plateaued at profound deafness. I have worn hearing aids since i was 3. I can sign bsl, i can lipread (speech read) and i’m a fluent oral speaker (i rely mostly on lipreading though- i cannot understand a conversation, for instance, if i’m not lipreading). I’m now 21 and am weighing up the pros and cons of getting a cochlear implant, and i live in the uk.

I’m particularly interested in the experiences of people who had a cochlear implant who were in a similar situation to me - i.e. They could communicate hear before the cochlear implant but not as well as a typical person, and there has been a notable delay between their deafness and getting a cochlear implant.

I don’t think that the experience of those who got a cochlear implant when very young, or after having normal hearing but became deaf when they were an adult will help me much in making my decision to get a cochlear implant.

I was born with profound deafness dx at 2 years old, I was brought up mostly oral due to schooling background but BSL was my first language. I got my CI at 30, yes it's different experince to those who was hearing before they became deaf, it was tough at first but I loved it, it gave me the sounds I never heard before but it had to be achieved through hard work. Not everyone are successful with their CI. And low expectations is important.

here’s a list of questions that i have. It’s quite a list but if you could answer any of them i would really appreciate it.

Questions anyone can answer:

Is it worth waiting for future technology? The techology is always changing, why wait.
do the current ci destroy the existing cochlear hairs?
It is possible.
if it doesn’t is the process theoretically reversible? E.g. Go from a ci back to a hearing aid? I don't think it's possible and you would need to ask your surgeon about this.
what are the present guidelines in the nhs re unilateral/bilateral ci, e.g. Could i get bilateral ci or is unilateral ci the best i could get? Unless you are physcially/visually disabled you can only have one funded (I hope the guidelines to change next year to allow adults to have choice of going bilateral.
how long do the ci last typically? I have heard the figure 70 years being bandied about.
They are made to last 70 years but guarateed for 10, at some point of your life you may need reimplantation.
what are the risks of the operation?
Minimal, balance loss/nauesa/recation to asthestic (sp)/nicked facial nerve, infection post op is known but rare, ask your surgeon about this.
what percentage of cochlear implantees have complications like the body rejecting the ci, losing your taste etc?I had lost my taste for few months and i know few people who had aswell, rejection is rare. Link to report, http://www.isvr.soton.ac.uk/soecic/news_files/progress report 2009.pdf
what are the best ci?
All ci's have successful rate, all works well, it's down to personal choice.

what ci do the nhs provide?
It is depends on your ci centre as they all are different, mine offers all 4.
which ci have the largest market penetration in the uk? Not known.

Questions for anybody who has had a ci:

Did you get unilateral/bilateral ci?Unilateral, wants to be bilateral but because of guidelines i cannot.
what difference do you think it makes?
For me, a lot since I hear very little with ha and heard no speech at all, now I can hear a lot more than I expected, understand speech better as it aids the lipreading better, I just started to understand sentences without lipreading.
did you get your unilateral ci in your best or worse ear?
Best ear.
why? Is it reasonable to think that my best ear would have the best results for a ci?
My better ear picks up sounds better with HA and is already stimulated but it up to you/your surgeon/audiologist to decide which is best for you.
what’s it like wearing a ci with a hearing aid? I have just started wearing more powerful ha in other ear which is very profound, the audiologist had put all the power on to 250hz so I can hear bit better and found it better since the CI is better at mid/high freq and the ha is better for low freq it kind of balances it out, each person experience differently.
what activities are curtailed? What sports should i avoid?
http://www.bcig.org.uk/downloads/pdfs/safety%20document%202008.pdf
i heard somewhere that ci don’t weaken the skull so there’s no additional skull strength issues to consider. Is this true?
How do you cope with living with a ci?
Easily, just like HA, at first I found a lot of sounds a bit overwhelming but I was able to cope with it
Do you cover up the ci?
I am a girl! Lol I do tie back my hair a lot and isn't bothered if people look at it
what precautions do you take?
not much, I still ski, ride horses, climb as much before I had the implant, although, I am just wiser than before

questions specifically for people in a similar situation to me:

Were you able to use the telephone after getting the ci? Could you do that before? (i can’t do it now, but if a ci could give me that ability then it would be a massive plus for me.)
I couldn't pre implant, 2 years post implant, I still find it hard, I only call my mum but that down to how much you work with your implant/use telephone/how confident you are but if I were you I wouldn't expect too much as alot of people took long time to achieve this, some never.
how did the range/sound distinction/amplification improve?
A lot as I can pick alot of sounds.
how long was the rehabilitation process?
Depends on individual and CI centre
could you listen to/appreciate music?
yes but I still cannot understand the lyrics but love to listen the sounds of different intruments(i can listen to a very small amount of music and would love to be able to hear much more than i can do now).

.

 

[drphil]

Hi: I am in Toronto Ontario- like you have NHS called OHIP. It picked up the entire cost was $55,000.00 CDN re- my Cochlear Implant/Surgeon's fee/Hospital care and audiologist services-pre/post operations/rehab etc. This all happened 3 years ago. It is a specialized section in Sunnybrook Hospital. They have to decide which/ who can benefit from receiving an Implant based on their assessment on one's health-survive the operation and what did they do to deal with their previous Hearing impairment- study on how to cope with Hearing Loss. I was involved with Cdn Hearing Society here in Toronto since 1992-Hearing Help classes--Speechreading. I understand Sunnybrook rejects over 60% for one reason or other. I understand that only 850 implants over the last 18 years have happened.
One of your questions relate to the use of telephones. My experience: can hear the dial tone but NOT persons speaking- thus continue to access the Relay service-711. Of course-disconnect my Implant. I have an UltraTec-VCO/Text 1140 TTY since Jan/96. I understand most persons with Implant have trouble using a regular phone. To me a minor problem in continuing to access the relay Service. I use Bell "telemessage service" as for leaving taped message which the Relay service can easily access on my behalf Just give them: number/password/whether to save or delete after keying . Whether such a system exists over there- I don't know.
The operation is not reversible- you can't "go back to Hearing Aids" under any circumstances.
It was discovered" recently" since I went to "singles dances" over the last 25 years that I helped my brain accept the Implant. Unbeknown to me-of course! Reason Loud music to quiet people voices! Dance steps don't count! I even went to a dance 3 days after activation in August/07 to test everything. Sounded weird to say the least! I actually became deaf on December 20/06.
Much success in new Hearing journey with an Cochlear Implant. Cheers

Advanced Bionics-Harmony Atria activated Aug/07

 

[sr171soars]

...
Here’s a list of questions that I have. It’s quite a list but if you could answer any of them I would really appreciate it.

Questions anyone can answer:

Is it worth waiting for future technology?

Depends. Technology is good enough to get decent results now. If you want perfection, you will be waiting a long time. Up to you.

Do the current CI destroy the existing cochlear hairs? If it doesn’t is the process theoretically reversible? E.g. Go from a CI back to a hearing aid?

Not really. No going back "per se". Maybe in the future. Who knows?

How long do the CI last typically? I have heard the figure 70 years being bandied about.

The outer part will be replaced periodically say every 5-10 years. The internal part (the electrode) is good for a lifetime. But as everybody knows, technology never stops improving. More than likely to eventually get a new and improved electrode 15-20 yrs down the road.

What are the risks of the operation? What percentage of cochlear implantees have complications like the body rejecting the CI, losing your taste etc?

All surgeries have risk. The main one is facial nerve paralysis (very unlikely and getting less so all the time). Body rejection of CI would be a very rare thing similar to metal reaction in some people. Theoretically, there shouldn't be but one or two have had problems along those lines. Losing taste is always a temporary thing.

What are the best CI?

There is no best CI as such. Up to you as nobody will be able to try all three given we have two ears.

Questions for anybody who has had a CI:

Did you get unilateral/bilateral CI? What difference do you think it makes?

Unilateral. At time I got mine, getting one CI was the standard. Nowadays, some decide to go bilateral. I haven't decided to go bilateral and may never do so. I'm doing too well with my one.

I will say given the choice, being bilateral would be better. The big reason is that one hears better with two inputs.

Did you get your unilateral CI in your best or worse ear? Why? Is it reasonable to think that my best ear would have the best results for a CI?

In my best ear. It generally considered that the good ear is the best ear for a CI given nature of the beast.

What activities are curtailed? What sports should I avoid?

Me personally, none as I don't scuba dive. Serious contact sports without a helmet and deep scuba diving.

I heard somewhere that CI don’t weaken the skull so there’s no additional skull strength issues to consider. Is this true?

True. There is a little gap right above the ear ridge on top.

How do you cope with living with a CI? Do you cover up the CI? What precautions do you take?

I'm in IT and have no problems. No, as I have short hair. None.

Questions specifically for people in a similar situation to me:

Were you able to use the telephone after getting the CI? Could you do that before? (I can’t do it now, but if a CI could give me that ability then it would be a massive plus for me.)

Yes, in fact I use it all the time, do conference calls, and etc. Please realized that phone usage is one of the "holy grails" of CI wearers and very few are really good with them. I just happen to be one of them.

How did the range/sound distinction/amplification improve?

A CI actually reduces your range of sound you can hear (mostly much higher pitches and some very low pitches). It vastly increased my ability to handle sound distinction. I have gone into automatic listening mode like the hearing and I could never really do that before.

How long was the rehabilitation process?

I didn't do or need rehabilitation. I was a going concern from day one. It was going full bore after about 4 days.

Could you listen to/appreciate music? (I can listen to a very small amount of music and would love to be able to hear much more than I can do now).

Love music and listen all the time.

I will say that listening with a CI is different that listening to a HA. A HA is more "natural" but one can adapt to anything. I have done that with my CI and really can't tell the difference anymore.

 

[set2]

I am a late deafened adult and I received a CI in my worst ear three years ago. The implant has allowed me to understand speech without lipreading (except in noise), enjoy music and use a regular telephone (not perfectly). I had speech understanding almost immediately but it took months to get to the level it is now. It took two years to really enjoy music again. I practiced hours with audiobooks and with exercises on the computer.

I have worn a hearing aid in my unimplanted ear and it did help with the low tones and in noisy situations. The hearing aid does not help like it used to so I will be going bilateral soon.

I had a short period of deafness before getting a CI and that was a factor in allowing me to do well. Being able to use a hearing aid in my unimplanted ear also helped with leanring to hear with the implant.

There will no doubt be better technology in the future but if I waited I would still be struggling and missing out. I was also concerned that if I waited my brain might not adjust as well to hearing with a CI as it would by getting an implant now.

 

[hugoboss84]

I know that some of these questions are probably outside of your experience because they are to do with the UK healthcare system and this seems to be mainly an American website. With that caveat...here goes:

My situation:

I was diagnosed with hearing impairment when I was 3. My hearing deteriorated until I was 6, where it has plateaued at profound Deafness. I have worn hearing aids since I was 3. I can sign BSL, I can lipread (speech read) and I’m a fluent oral speaker (I rely mostly on lipreading though- I cannot understand a conversation, for instance, if I’m not lipreading). I’m now 21 and am weighing up the pros and cons of getting a cochlear implant, and I live in the UK.

I have a very similar case than yours, around 95% similar. And yes, I only decided on a CI at age 23 and wore HA all along since 5. I managed just fine with lip reading and support from family/friends. But I could definitely not be an independent person. And I have never learnt any sign language or felt the need to.

I’m particularly interested in the experiences of people who had a cochlear implant who were in a similar situation to me - i.e. They could communicate hear before the cochlear implant but not as well as a typical person, and there has been a notable delay between their deafness and getting a cochlear implant.

I don’t think that the experience of those who got a cochlear implant when very young, or after having normal hearing but became Deaf when they were an adult will help me much in making my decision to get a cochlear implant.

Here’s a list of questions that I have. It’s quite a list but if you could answer any of them I would really appreciate it.

Questions anyone can answer:

Is it worth waiting for future technology?

Depends. Technology is changing at a very fast pace. The longer you wait, the lesser you are going to reap the full benefits of a CI. And it does take even longer to adjust to a CI if you have been profoundly deaf for years. Better to consider getting one now if you want your quality of life to improve.

Do the current CI destroy the existing cochlear hairs? If it doesn’t is the process theoretically reversible? E.g. Go from a CI back to a hearing aid?

In most cases, hair cells do get destroyed. But with newer technologies & better surgical techniques, hair cells are being preserved. I have some residual hearing left that can be amplified with HA, but it is only 2% and speech recognition is impossible. Once you go for a CI, there is no turning back. And HA are 10 times less advanced than a CI; I dont think I have ever come across someone going from CI to HA.

What are the present guidelines in the NHS re unilateral/bilateral CI, e.g. Could I get bilateral CI or is unilateral CI the best I could get?

No idea, am not from UK. Two ears are better than one, but I wanted to go unilateral (or call it binaural - CI and HA together) for a few years before going bilateral.

How long do the CI last typically? I have heard the figure 70 years being bandied about.

I have heard it lasts a lifetime or 100 years or so.

What are the risks of the operation? What percentage of cochlear implantees have complications like the body rejecting the CI, losing your taste etc?

There is a risk of facial paralysis. The best you can do is approach a reputed and experienced surgeon who has done plenty of CI operations. Losing taste happens temporarily for a few days after surgery, but thats just a small side effect of surgery. All surgeries do have a side effect.

What are the best CI? What CI do the NHS provide? Which CI have the largest market penetration in the UK?

Questions for anybody who has had a CI:

Did you get unilateral/bilateral CI? What difference do you think it makes? Did you get your unilateral CI in your best or worse ear? Why? Is it reasonable to think that my best ear would have the best results for a CI? What’s it like wearing a CI with a hearing aid?
What activities are curtailed? What sports should I avoid? I heard somewhere that CI don’t weaken the skull so there’s no additional skull strength issues to consider. Is this true?
How do you cope with living with a CI? Do you cover up the CI? What precautions do you take?

Questions specifically for people in a similar situation to me:

Were you able to use the telephone after getting the CI? Could you do that before? (I can’t do it now, but if a CI could give me that ability then it would be a massive plus for me.)

I used to be able to talk over the cellphone "without" HA and at the highest volume. But I have never been able to get the speaker's speech perfectly clear. As my hearing deteriorated, I gave up the telephone and lost confidence in using it. After CI, I have been talking over the phone gradually, both on a regular phone, a cellphone (without telecoil) and a Captel (speech to text phone) for assistance sometimes. I have been told for years by Audiologists that I will never be able to regain hearing on the phone, but I am sure I can atleast make 70% of it, if not 100%. I am not a fan of using TTYs, and I am hopeful of getting away with Captels too as I start practicing more over the phone and building my confidence.

How did the range/sound distinction/amplification improve?

It improved quiet alot unexpectedly, but it was not sudden. The results were taken every 6 months and I have learnt to pick up so many different sounds, especially high pitch sounds. I am even more surprised to learn how bad my speech has been because I could not hear much all these years, but I am learning day-by-day. Its a miracle to be able to hear again with a CI. But if you have high expectations, you are surely going to be disappointed.

How long was the rehabilitation process?

It depends from person to person. Since I have been on/off HA since childhood, my rehab is expected to take longer like 1-2 years or so. One needs to do regular aural and speech practice in order to get rehabilitated. And patience is the key here. There will be frustrations, but thats all part of the process of getting better with CIs.

Could you listen to/appreciate music? (I can listen to a very small amount of music and would love to be able to hear much more than I can do now).

Earlier I used to love the drum-beats and background scores. Now I enjoy music even more by listening to the actual song. Yes, the background music is still not as what I expected (if you are a fan of instrumentals, etc.), but the Cochlear Implant was not designed to keep music in mind; ongoing research for music improvement is underway for future CI technologies.

Responses in BLUE. Hope that helps!

 

[davidlawson]

Thanks Overthepond, sr171soars and hugoboss84. That's really useful info.

Two more questions specifically for you overthepond - since you are from the UK: how hopeful are you that NICE will change the guidelines so that adults can have bilateral CI? If they are going to do that it might make sense to wait. Also, can you get a topup with CI? Ie the NHS pay for one CI while you pay for the other?

 

[overthepond]

I am not sure to be honest David, with today's recession/goverment change, who knows but I have been asking for 2nd one, they have me on their waiting list but cannot start the assessment until the NICE changes that if they would change to allow adults to have 2nd implant. I wouldn't wait, they could change the guidelines to no implants for adults!

You can fund for 2nd implant but it's very expensive with @ £30,000 to pay just for the first year (surgery, rehab etc)... and around 100-2,000 per year and thereafter for the rest of your life for things like repairs/batteries/replacements, Tune ups, yearly check up. As for upgrading the processor is expensive too. The NHS won't co pay (ie pay part of it) I know because someone tried. In my opinion if you have useful ear I'd stick with hearing aid until NICE guidelines changes but I would get referral for the least useful ear ASAP. Thats all I know but the best person to ask would be your Consultant.

Are you based in the south?

 

[hugoboss84]

30,000 pounds a year? Thats a crazy amount without any insurance coverage. And again 1000-2000 a year is also too much. Doesn't NHS cover the costs for mapping, rehab, etc. ?

 

[lovezebras]

she means if you are paying out of pocket for a 2nd CI i believe NHS is similar to canada with health care and the first implant IS covered, surgery, rehab, MAPpings, etc but only for ONE implant...not many ppl are able to go bilateral here in canada/uk but some do but then again if they do it's mostly children

 

[Deaffy]

My insurance only coverd my 1st CI... If I wanted a second w( I would loveeeeeeeeeee to) I would have to pay out of pocket or shop around for a insurance company that would be willing to cover it. I will be scraping pennies to pay my co-pay off for the first CI. But in the end its definately worth it. As of right now.. the power that 1 CI cn give is enough for me for quite sometime. Im hearing nearly as good as I could ( back when I only had one good ear anyhow) So to me its worth it. I have never heard out of 2 ears so i dont think it would be benefical for me iI think it would confuse me more than anything.

 

[overthepond]

Alicia is right about what I am saying. Yeah we don't even have ANY insurance coverage in UK for implant/s.

The guidelines/NHS states that children under 19 having stimi bilateral operation is most cost effective, sequential would be fought for sometimes successful sometimes not sucessful. Adults - nope point blank as there is not much evidence that being bilateral is benefitcal for adults. The adults who are allowed (with fight) to go bilateral are registered blind/ or physically disabled.

 

[overthepond]

I am not sure to be honest David, with today's recession/goverment change, who knows but I have been asking for 2nd one, they have me on their waiting list but cannot start the assessment until the NICE changes that if they would change to allow adults to have 2nd implant. I wouldn't wait, they could change the guidelines to no implants for adults!

You can fund for 2nd implant but it's very expensive with @ £30,000 to pay just for the first year (surgery, rehab etc)... and around 100-2,000 per year and thereafter for the rest of your life for things like repairs/batteries/replacements, Tune ups, yearly check up. As for upgrading the processor is expensive too. The NHS won't co pay (ie pay part of it) I know because someone tried. In my opinion if you have useful ear I'd stick with hearing aid until NICE guidelines changes but I would get referral for the least useful ear ASAP. Thats all I know but the best person to ask would be your Consultant.

Are you based in the south?

Hugo, I have highlighted in bold "just for 1st year" and "100 (not 1000) to 2000 per year" afterwards for after care, this is a guideline and it depends on individual. I can give you excat amount later when I find the 2008-9 report.

 

[davidlawson]

Wow... 30 grand is a lot of money.

I wonder how strictly they follow the NICE guidelines since I'm 21 and only a few years older than the eligible category.

I'll find out soon. I'm going to my GP tomorrow to ask for a referral to a cochlear implant specialist!

And no, I'm not based in the south. I'm a Yorkshire man.

 

[Lissa]

I am not sure to be honest David, with today's recession/goverment change, who knows but I have been asking for 2nd one, they have me on their waiting list but cannot start the assessment until the NICE changes that if they would change to allow adults to have 2nd implant. I wouldn't wait, they could change the guidelines to no implants for adults!

You can fund for 2nd implant but it's very expensive with @ £30,000 to pay just for the first year (surgery, rehab etc)... and around 100-2,000 per year and thereafter for the rest of your life for things like repairs/batteries/replacements, Tune ups, yearly check up. As for upgrading the processor is expensive too. The NHS won't co pay (ie pay part of it) I know because someone tried. In my opinion if you have useful ear I'd stick with hearing aid until NICE guidelines changes but I would get referral for the least useful ear ASAP. Thats all I know but the best person to ask would be your Consultant.

Are you based in the south?

I was assessed for another CI in October 09' since I was 18 when the bilateral guidelines came out. I haven't heard any more so I assumed it was a no. I am just wondering if NICE change their guidelines so adults can have 2, do you think my assessment will still stand?

 

[hugoboss84]

Hugo, I have highlighted in bold "just for 1st year" and "100 (not 1000) to 2000 per year" afterwards for after care, this is a guideline and it depends on individual. I can give you excat amount later when I find the 2008-9 report.

Sorry I didnt read that part about 100-2k carefully, but I still think 30k british pounds for a second CI is way too much. I mean, shouldn't the NHS know that bilaterals would be helpful to adults as well? What if a CI surgeon provides sufficient proof to NHS that a bilateral is needed for the individual to be able to hear? I have seen in US people who are profoundly deaf presenting their case to insurance companies with sufficient proof from their doctors about the need for a second CI. And now, as of 2009, one US insurance company definitely covers bilateral as well.

I lived in Canada for sometime and at that time my insurance didnt cover CIs. I figured my out-of-pocket expense would be too much for even one CI - around CN$65,000. Thats pretty high as well!

 

[overthepond]

I was assessed for another CI in October 09' since I was 18 when the bilateral guidelines came out. I haven't heard any more so I assumed it was a no. I am just wondering if NICE change their guidelines so adults can have 2, do you think my assessment will still stand?

You need to contact your centre to find out. They rarely contact people, you need to remind them that you are still interested... one way or other they only can say no.

 

[overthepond]

Sorry I didnt read that part about 100-2k carefully, but I still think 30k british pounds for a second CI is way too much. I mean, shouldn't the NHS know that bilaterals would be helpful to adults as well? What if a CI surgeon provides sufficient proof to NHS that a bilateral is needed for the individual to be able to hear? I have seen in US people who are profoundly deaf presenting their case to insurance companies with sufficient proof from their doctors about the need for a second CI. And now, as of 2009, one US insurance company definitely covers bilateral as well.

I lived in Canada for sometime and at that time my insurance didnt cover CIs. I figured my out-of-pocket expense would be too much for even one CI - around CN$65,000. Thats pretty high as well!

No worries, Hugo, From what I have been told.... There are not much evidence/adults in UK that have 2 implants hence the money goes to the kids... But hey, what about OUR rights since many of us pay the tax! At the moment there had been goverment change and we are hoping that the guidlines would change in 2011, who knows but with today's money I doubt that the adults would get 2nd implant unless they are blind/physcially disabled.