The hearing and cochlear implant debate! Share your opinion! - Page 2

deafdyke · 03-22-2009, 01:23 AM

Quote:

It's no different than what hearing aid manufacturers do.

Where do you get the idea that CI companies manipulate research?

Not exactly Hear Again. The promotion of CIs seems to be a lot more aggressive now, especially since they've loosened the qualifications of who can get one now. Yes, there is a significent population for whom the CI is the ONLY option. Nothing wrong with marketing the CI to them.
However, it does seem like they are promoted as THE ANSWER. I'm not sure if you remember in the 90's how they were promoting digital aids as THE ANSWER to everyone's hearing woes. They were marketing them in the same way that CIs are being marketed now. I remember back then, they implied that digital aids were THE ANSWER. Guess what? People are still wearing analogs. Matter of fact, research has shown that when an aid is labeled digital, people report better perfomance from it, even if it's just an analog aid!
It also seems like.....there's a huge difference between health care decisions. Back in the 90's, it seemed to be more about professional driven health care....the doc or audi would say " I think you've maxed out your hearing aids...maybe it's now time for CI."
It's still somewhat present, but now it seems to be more about "having the Detrol (CI) conversation with your doc....you know?
I never said CI companies manipulate research....it's just that having CI companies say that CIs are better then HA, is like the company that manufactures Tylenol saying that Tylenol is better then Advil or whatever the competiting product is.

**Daredevel7** · 03-22-2009, 09:06 AM

There's a lot of talk about loosing up the qualifications of the CI. I don't particularly understand the negativity towards this. Pretend the CI works well for 95% of the population (which it does, but some people don't believe it). When I say works well, I mean they eventually get more than half of speech discrimination. When they started the CI, it was new and experimental, so of course they had restrictions and would only give it to those who had nothing or minimal hearing to lose. After 20 years, and seeing the tremendous success, wouldn't it make sense for them to loosen up and still give the CI to those who DO have residual hearing but have little to no speech discrimination? Hearing at 30dB at a certain frequency doesn't mean ANYTHING if you hear everything else at 90dB.

Obviously I am against giving the CI to someone who has enough residual hearing to have relatively good speech discrimination. The problem is when someone says "Oh I have a hearing loss with the range of 50-90dB and I got the CI". Some people get into an uproar, but they interpreted the dB loss as moderate and think they have good enough hearing. That's no better than someone assuming that a HoH can hear everything.

**shel90** · 03-22-2009, 09:13 AM

Quote:

Originally Posted by Hear Again

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?

Simple. Louder = distortion

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.

Research has proven time and time again that people with a greater amount of residual hearing benefit significantly from a CI.

Because of that, I dont think I would be a good candidate for a CI since I dont have much residual hearing.

As for the comments about not benefiting from residual hearing...despite with the little I have, I rely on it heavily when in non signing environments. Some deaf people do use what little residual hearing they have in several situations.

Hear Again · 03-22-2009, 04:11 PM

Quote:

Originally Posted by shel90

As for the comments about not benefiting from residual hearing...despite with the little I have, I rely on it heavily when in non signing environments. Some deaf people do use what little residual hearing they have in several situations.

Some deaf people are better at using their residual hearing than others.

Furthermore, some deaf people don't know sign or have the ability to lipread which may explain why they choose to receive a CI.

Hear Again · 03-22-2009, 04:14 PM

Quote:

Originally Posted by Daredevel7

There's a lot of talk about loosing up the qualifications of the CI. I don't particularly understand the negativity towards this. Pretend the CI works well for 95% of the population (which it does, but some people don't believe it). When I say works well, I mean they eventually get more than half of speech discrimination. When they started the CI, it was new and experimental, so of course they had restrictions and would only give it to those who had nothing or minimal hearing to lose. After 20 years, and seeing the tremendous success, wouldn't it make sense for them to loosen up and still give the CI to those who DO have residual hearing but have little to no speech discrimination? Hearing at 30dB at a certain frequency doesn't mean ANYTHING if you hear everything else at 90dB.

Obviously I am against giving the CI to someone who has enough residual hearing to have relatively good speech discrimination. The problem is when someone says "Oh I have a hearing loss with the range of 50-90dB and I got the CI". Some people get into an uproar, but they interpreted the dB loss as moderate and think they have good enough hearing. That's no better than someone assuming that a HoH can hear everything.

Hear Again · 03-22-2009, 04:19 PM

Quote:

Originally Posted by deafdyke

Not exactly Hear Again. The promotion of CIs seems to be a lot more aggressive now, especially since they've loosened the qualifications of who can get one now.

DD,

I don't understand why you think doctors are promoting CIs to everyone who walks in the door because that simply isn't true.

For starters, in order for someone to discuss CIs, they need to visit a qualified CI center. Most ENTs are unfamiliar with CIs and don't know the criteria for being a candidate. My former ENT recommended that I have an MEI due to continuing hearing loss. After I saw a specialist, I was told that I didn't have enough residual hearing. When I asked about a CI (since he was also a CI surgeon), I was told that I had "a little too much" residual hearing since my aided speech discrimination at the time was 30-40%.

If you want to believe that CI companies hype their products to everyone, go ahead. I happen to disagree. It has been said that over 20,000 adults and children qualify for CIs, but do not have them because they are unaware of the technology.

As for loosening CI criteria, what's the difference? Research has proven that people with greater amounts of residual hearing benefit from a CI. Why do you have a problem with that? If they choose to receive a CI, how does that negatively affect you?

deafdyke · 03-22-2009, 10:53 PM

Quote:

There's a lot of talk about loosing up the qualifications of the CI. I don't particularly understand the negativity towards this.

Well say that the CI really is ALL THAT. Where should the dividing line be between the person who is obviously qualified for it, vs someone who has bought into the thinking that "it's the newest and latest thing" so I GOTTA have it?
Again, I have NO BEEF whatsoever, with people who are totally right off the bat canidates or who have maxed out their amplification.
But I'm just curious.....where's the dividing line? This really isn't say for example akin to the switch from earhorns to hearing aids.
I think people need to be careful about thinking that the "latest technology" is always the best. Yes, some people have experianced some amazing sucess with CI (ie they go from little to no or some speech discrimination to being functionally hoh)but that's led some people to think that it overcomes ALL the inequalities of being hoh.
You know.......does anyone know if sales of hearing aids for profound losses have gone down in recent years?
It's hard to say since there's no hard data out there with which to really back up the debate.
It's very possible that a lot of the people who are ambigious canidates for CI, are the AG Bell- Auditory Verbal types who need the latest hearing aid or whatever.
It doesn't effect me, directly, but it does mean that if more people opt for CI then that means highr health insurance premieums etc.

lovezebras · 03-22-2009, 11:46 PM

so ppl who think its the latest fad that will solve their probs are going to be told by their surgeon and ci audi that you need to do therapy etc and if they still get it and don't get what they were wanting cuz they don't do therapy and such then it's their own fault for proceeding with getting a CI

Hear Again · 03-23-2009, 01:28 AM

Quote:

Originally Posted by deafdyke

It's very possible that a lot of the people who are ambigious canidates for CI, are the AG Bell- Auditory Verbal types who need the latest hearing aid or whatever.
It doesn't effect me, directly, but it does mean that if more people opt for CI then that means highr health insurance premieums etc.

That's quite an unfair generalization to make, DD. I have bilateral CIs and I'm not an AG Bell AVT type.

Besides, what's wrong with advocating for AVT? When someone opts to have a CI, speech understanding should be the main focus if a person is able to use their hearing to that extent.

Where do you get the idea that CIs result in higher health insurance premiums? The more people who receive CIs, the less health insurance will cost due to there no longer being a need for ENT services, hearing aid programming and hearing tests.

CI candidates put a great deal of research into deciding to be implanted. Sooner or later, the reality of what it means to be a CI candidate (i.e. the strongest amplification no longer helps) hits home and they mourn the loss of their hearing.

If anyone opts for a CI because it's "the latest and greatest technology," they are a very small minority of CI candidates.

Hear Again · 03-23-2009, 01:33 AM

Quote:

Originally Posted by AliciaM

so ppl who think its the latest fad that will solve their probs are going to be told by their surgeon and ci audi that you need to do therapy etc and if they still get it and don't get what they were wanting cuz they don't do therapy and such then it's their own fault for proceeding with getting a CI

deafdude1 · 03-23-2009, 05:33 AM

Thanks for your replies in this debate. My post will contribute to the debate and address some of your replies. deafdyke has alot of good points in her posts. Like me, she also is neutral towards CI. Neither of us are against the profoundly deaf who are "off the bat" candidates. But those who are moderately "deaf" should never be CI candidates, probably not ever.

deafdyke made an interesting remark that if you promote an analog aid as "digital" people will somehow think it's better! While I have yet to see ADs for CI, I wouldn't be surprised when the time comes, probably when totally implantable CIs get FDA approval. ADs will say "ditch your HAs and enjoy invisible, natural hearing with implantable cochlear implants" and show a "before" and "after" picture. There may also be ADs for implantable hearing aids for the mild to moderate HOH. What's the point when you can get a CIC or mini open fit BTE hearing aid and save a fortune and avoid the risks?

Additionally, I am seeing people considering CI even though they did NOT max their HAs and/or they are NOT wearing the most powerful HAs. Even my HAs probably aren't maxed out and I am getting them reprogrammed for max gain and enable transposition so I "hear" high frequencies. CI was and still should be a last resort. It's not something you "gotta" have as the latest and greatest or to "upgrade" your perfectly working HAs but as a last and only resort! CI can be better than HA for "off the bat" candidates but it's high risk for "ambigious" candidates, even Shel said 30% of CI users recieve little or no benefit.

Daredevel7....................

That 95% is suspect. From reading blogs and talking to others, it appears that 75% are satisfied. Maybe CI does works for 95%, but that doesn't mean everyone with a working CI will be satisfied. There could be all kinds of reasons a quarter of CI wearers aren't satisfied. Just because someone is a candidate doesn't mean itll always work and even if it works that youll be happy and satisfied. That's why people need to do their research and be 100% informed and have realistic expectations. They should also refer to their unaided/aided audiogram and do the math to determine how much better(or worse) a CI will be over what they hear.

So you say CI can give a person 50% to 75% speech discrimination? Some HA wearers already get close to that with both HAs in. But they hear environmental sounds great and may in fact hear less environmental sounds with their CI. That could explain one of the reasons for 25% of CI wearers being unhappy. Too much emphasis is placed on speech perception while ignoring the other benefits of HA.

If a person hears at 30db and at 90db, they need better HAs or boost the gain. I hear 15db at 250Hz but only 80db at 2000Hz. I am going to get my HAs tested tomorrow at my audiologist then im going to have my other audiologist who sold me those HAs reprogram them and enable transposition so I hear the best I can and should.

A person with 50db to 90db sloping loss has a moderate to severe hearing loss. CI is for severe(70db) to profound(90+db) hearing loss. Yes we would be in an uproar at any moderates who somehow qualified for CI.

shel90(and others) I always thought the less residual hearing a person has, the better they would be for CI since they have more to gain, less to risk/lose. Even I would seriously consider getting CI if I lost another 10-15db of hearing. This would render me totally deaf above 500Hz and profoundly deaf below 500Hz. At this point, CI would indeed have a 95% chance of being better than what id hear with HAs. Right now with my residual hearing, id give it a 60% chance of being better than HAs(im factoring in environmental sounds too, not just speech)

deafdude1 · 03-23-2009, 05:56 AM

Quote:

Originally Posted by Hear Again

When I asked about a CI (since he was also a CI surgeon), I was told that I had "a little too much" residual hearing since my aided speech discrimination at the time was 30-40%.

Yet this lady I know has a 40db sloping HL(NON progressive!) and 60% speech discrimination/perception with both HAs somehow got approved by insurance and her surgeon. She hears unaided much better than you used to hear aided with HAs before you got CIs!

Actually she didn't want CI and said her HAs were doing the job just fine. Her ENTs and audiologists kept recommending CI to her(probably so they can get a commission) and it sounds like she's being pressured into CI. The fact her insurance and surgeon somehow approved her made her think CI will be "the latest and greatest" and she thinks it will be better than HAs or her moderate sloping loss. I gotta be blunt and honest and say theres a very high chance she will be unhappy with CI and find it worse than HA and she will really miss hearing sounds unaided if she loses some/all residual hearing.

Quote:

As for loosening CI criteria, what's the difference? Research has proven that people with greater amounts of residual hearing benefit from a CI. Why do you have a problem with that? If they choose to receive a CI, how does that negatively affect you?

Still her hearing loss is NOT severe-profound! Nor is it progressive! If criteria has been loosened so much that moderate HL is getting CI, millions of people will try to get CI. How will insurance pay for all those people? They will go out of business! Also there will be a ton of unhappy CI users who hear much worse than they did with HAs.

Quote:

Originally Posted by Hear Again

Where do you get the idea that CIs result in higher health insurance premiums? The more people who receive CIs, the less health insurance will cost due to there no longer being a need for ENT services, hearing aid programming and hearing tests.

That lady getting CIs even told me that insurance has raised their premiums because they have loosened their criteria and they need everyone else to pay a higher monthly insurance cost to subsidize those who feel like getting CI. Those who don't want CIs will wisen up and switch to a cheaper insurance with strict CI criteria and save hundreds a month on their insurance.

Quote:

Originally Posted by Hear Again

CI candidates put a great deal of research into deciding to be implanted. Sooner or later, the reality of what it means to be a CI candidate (i.e. the strongest amplification no longer helps) hits home and they mourn the loss of their hearing.

That lady did do some research and decided not to get CI but changed her mind only because her insurance and surgeon somehow approved her. She has only moderate hearing loss and hears great with HAs. So now she thinks CI will somehow be better because her insurance and surgeon "said" so. How's that for lax standards and willy-nilly approval?

Quote:

Originally Posted by Hear Again

If anyone opts for a CI because it's "the latest and greatest technology," they are a very small minority of CI candidates.

She happens to be in that (growing) minority.

faire_jour · 03-23-2009, 01:13 PM

Quote:

Originally Posted by deafdude1

Yet this lady I know has a 40db sloping HL(NON progressive!) and 60% speech discrimination/perception with both HAs somehow got approved by insurance and her surgeon. She hears unaided much better than you used to hear aided with HAs before you got CIs!

Actually she didn't want CI and said her HAs were doing the job just fine. Her ENTs and audiologists kept recommending CI to her(probably so they can get a commission) and it sounds like she's being pressured into CI. The fact her insurance and surgeon somehow approved her made her think CI will be "the latest and greatest" and she thinks it will be better than HAs or her moderate sloping loss. I gotta be blunt and honest and say theres a very high chance she will be unhappy with CI and find it worse than HA and she will really miss hearing sounds unaided if she loses some/all residual hearing.

Still her hearing loss is NOT severe-profound! Nor is it progressive! If criteria has been loosened so much that moderate HL is getting CI, millions of people will try to get CI. How will insurance pay for all those people? They will go out of business! Also there will be a ton of unhappy CI users who hear much worse than they did with HAs.

That lady getting CIs even told me that insurance has raised their premiums because they have loosened their criteria and they need everyone else to pay a higher monthly insurance cost to subsidize those who feel like getting CI. Those who don't want CIs will wisen up and switch to a cheaper insurance with strict CI criteria and save hundreds a month on their insurance.

That lady did do some research and decided not to get CI but changed her mind only because her insurance and surgeon somehow approved her. She has only moderate hearing loss and hears great with HAs. So now she thinks CI will somehow be better because her insurance and surgeon "said" so. How's that for lax standards and willy-nilly approval?

She happens to be in that (growing) minority.

I will take your bet. If she works hard and does her follow up, I bet she loves her CI. You don't seem to understand that 60% speech recognition is crappy! If you could have the opportunity to have scores closer to 90%, would you take it? I would do it for my child (and myself if I needed to) and I did.

Hear Again · 03-23-2009, 01:23 PM

Yet this lady I know has a 40db sloping HL(NON progressive!) and 60% speech discrimination/perception with both HAs somehow got approved by insurance and her surgeon. She hears unaided much better than you used to hear aided with HAs before you got CIs!

That's the exception rather than the rule. The audi who fitted me with my first pair of hearing aids has been in practice since 1985 (perhaps longer than that -- I don't know) and yet she was unfamiliar with CI candidacy criteria. When I asked her if she thought I would qualify, her exact words were, "I don't know. With a 90+ dB loss, you might."

By the way, it isn't uncommon for people with good low frequency hearing and severe or profound loss in the mid and high frequencies to be approved for a CI. I know someone who qualifed for a CI that had normal low frequency hearing which sharply dropped to profound in the mid and high frequencies.

I agree with faire_jour. Even if this person could hear 60% of speech, what's wrong with opting for a CI when she has the potential to hear 90% or better? Remember too that the world is not a sound proof booth. This person could have had *alot* of difficulty communicating in background noise. If that was the case, I'm glad she was approved for a CI.

Hear Again · 03-23-2009, 01:29 PM

Still her hearing loss is NOT severe-profound! Nor is it progressive! If criteria has been loosened so much that moderate HL is getting CI, millions of people will try to get CI. How will insurance pay for all those people? They will go out of business! Also there will be a ton of unhappy CI users who hear much worse than they did with HAs.

No offense, but what difference does it make to you? If you're happy with hearing aids, good for you. If this person isn't happy with hers, she has every right to decide to get a CI.

As for insurance, if they can pay for Viagra, they can pay for CIs too.

Insurance companies won't go out of business if they continue paying for CIs. They insure other health conditions -- not just CI evaluations, surgery and mappings.

How do you know that someone with a moderate loss would be unhappy with a CI? No one can predict how well a person will hear until after they've received a CI.

Besides, research has proven time and time again that people with greater amounts of residual hearing perform very well with a CI.

Hear Again · 03-23-2009, 01:33 PM

She has only moderate hearing loss and hears great with HAs. So now she thinks CI will somehow be better because her insurance and surgeon "said" so. How's that for lax standards and willy-nilly approval?

"Only moderate hearing loss." That's funny coming from someone who has had poor hearing all of their life. How do you know what it's like to hear with a moderate hearing loss? Some people with moderate hearing loss have more difficulty understanding speech than those with a severe loss.

If her speech discrimination was 60% or less in her better ear and 40% or less in her worse ear, insurance was correct in approving her. Those are the standards that need to be met. End of story.

Hear Again · 03-23-2009, 01:35 PM

She happens to be in that (growing) minority.

A minority that may be growing, but is still a minority when compared to the majority.

faire_jour · 03-23-2009, 01:37 PM

Quote:

Originally Posted by Hear Again

Still her hearing loss is NOT severe-profound! Nor is it progressive! If criteria has been loosened so much that moderate HL is getting CI, millions of people will try to get CI. How will insurance pay for all those people? They will go out of business! Also there will be a ton of unhappy CI users who hear much worse than they did with HAs.

No offense, but what difference does it make to you? If you're happy with hearing aids, good for you. If this person isn't happy with hers, she has every right to decide to get a CI.

As for insurance, if they can pay for Viagra, they can pay for CIs too.

Insurance companies won't go out of business if they continue paying for CIs. They insure other health conditions -- not just CI evaluations, surgery and mappings.

How do you know that someone with a moderate loss would be unhappy with a CI? No one can predict how well a person will hear until after they've received a CI.

Besides, research has proven time and time again that people with greater amounts of residual hearing perform very well with a CI.

I have never personally met a person who got a CI and then could hear worse (after appropraite time and work) than with their hearing aids. I have know people who didn't like them and chose to take them off, but they didn't like hearing aids either. I also know a few who got seemingly no benefit from the implant, but again, they had no benefit from hearing aids either. It didn't make it worse, it was just the same. But on the other hand, I know TONS of both children and adults who get great benefit from the CI. Not all the benefit is the same, some get enviromental sounds (which they didn't have with aids), some get speech awareness (which they didn't have with aids), some get speech comprehension (which they didn't have with aids) and some can talk on cell phones to strangers (which they certainly could never have done with heaing aids).

**Bottesini** · 03-23-2009, 01:39 PM

Quote:

Originally Posted by faire_jour

I have never personally met a person who got a CI and then could hear worse (after appropraite time and work) than with their hearing aids. .

I personally know two, both in their twenties. No residual hearing after surgery and a poor CI result.

Hear Again · 03-23-2009, 01:40 PM

A person with 50db to 90db sloping loss has a moderate to severe hearing loss. CI is for severe(70db) to profound(90+db) hearing loss.

Not necessarily. If a person has moderately-severe to profound loss in one ear and severe-profound (or profound) in the other in addition to a progressive hearing loss, they would qualify for a CI and rightfully so IMO.

faire_jour · 03-23-2009, 01:41 PM

Quote:

Originally Posted by Bottesini

I personally know two, both in their twenties. No residual hearing after surgery and a poor CI result.

But they heard well with their hearing aids? They did their follow up therapy and MAPing?

Hear Again · 03-23-2009, 01:41 PM

Quote:

Originally Posted by faire_jour

I have never personally met a person who got a CI and then could hear worse (after appropraite time and work) than with their hearing aids. I have know people who didn't like them and chose to take them off, but they didn't like hearing aids either. I also know a few who got seemingly no benefit from the implant, but again, they had no benefit from hearing aids either. It didn't make it worse, it was just the same. But on the other hand, I know TONS of both children and adults who get great benefit from the CI. Not all the benefit is the same, some get enviromental sounds (which they didn't have with aids), some get speech awareness (which they didn't have with aids), some get speech comprehension (which they didn't have with aids) and some can talk on cell phones to strangers (which they certainly could never have done with heaing aids).

**Bottesini** · 03-23-2009, 01:42 PM

Quote:

Originally Posted by faire_jour

But they heard well with their hearing aids? They did their follow up therapy and MAPing?

Of course the follow up therapy and MAPs. Not well with aids, but some, which to me is better than nothing.

faire_jour · 03-23-2009, 01:43 PM

Quote:

Originally Posted by Bottesini

Of course the follow up therapy and MAPs. Not well with aids, but some, which to me is better than nothing.

They hear nothing with the CI?

**Bottesini** · 03-23-2009, 01:44 PM

Quote:

Originally Posted by Hear Again

She has only moderate hearing loss and hears great with HAs. So now she thinks CI will somehow be better because her insurance and surgeon "said" so. How's that for lax standards and willy-nilly approval?

"Only moderate hearing loss." That's funny coming from someone who has had poor hearing all of their life. How do you know what it's like to hear with a moderate hearing loss? Some people with moderate hearing loss have more difficulty understanding speech than those with a severe loss.

If her speech discrimination was 60% or less in her better ear and 40% or less in her worse ear, insurance was correct in approving her. Those are the standards that need to be met. End of story.

I am curious, do you get paid or get benefit from advocating for CI?

Hear Again · 03-23-2009, 01:44 PM

If a person hears at 30db and at 90db, they need better HAs or boost the gain.

This does not account for clarity. I was able to hear at 60-70 dB aided and (against my audi's wishes) I had the gain on my aids increased, but it did absolutely nothing to improve my speech discrimination.

**Bottesini** · 03-23-2009, 01:46 PM

Quote:

Originally Posted by faire_jour

They hear nothing with the CI?

Both are friends of my children. I don't think nothing. But nothing useful.

Both have no speech.

faire_jour · 03-23-2009, 01:47 PM

Quote:

Originally Posted by Bottesini

Both are friends of my children. I don't think nothing. But nothing useful.

Both have no speech.

That my point. If they couldn't hear speech before the CI and they can't after, that is not a loss of hearing.

Hear Again · 03-23-2009, 01:51 PM

Quote:

Originally Posted by Bottesini

I am curious, do you get paid or get benefit from advocating for CI?

No.

I advocate for CIs because I'm a CI recipient and enjoy sharing my experiences with others.

Having said that, I also advocate the use of ASL. I'm neither 100% pro-oral or 100% pro-ASL. I believe in a person using whatever comunication technique or techniques work best for them.

**Bottesini** · 03-23-2009, 01:52 PM

Quote:

Originally Posted by faire_jour

That my point. If they couldn't hear speech before the CI and they can't after, that is not a loss of hearing.

In that you have a point, but the metal plate and magnet in the head, dizziness and other potential complications really bother me.

I guess the fact it was no benefit bothers me a lot too. The one I know best had hearing parents and lost his hearing to antibiotics at 18 months.

They wanted him to hear most desperately and I felt very sorry for him when he was not meeting their expectations.

03-23-2009, 05:33 AM	#41 (permalink)
deafdude1 Registered User Join Date: Feb 2009 Posts: 1,269 Blog Entries: 1	Thanks for your replies in this debate. My post will contribute to the debate and address some of your replies. deafdyke has alot of good points in her posts. Like me, she also is neutral towards CI. Neither of us are against the profoundly deaf who are "off the bat" candidates. But those who are moderately "deaf" should never be CI candidates, probably not ever. deafdyke made an interesting remark that if you promote an analog aid as "digital" people will somehow think it's better! While I have yet to see ADs for CI, I wouldn't be surprised when the time comes, probably when totally implantable CIs get FDA approval. ADs will say "ditch your HAs and enjoy invisible, natural hearing with implantable cochlear implants" and show a "before" and "after" picture. There may also be ADs for implantable hearing aids for the mild to moderate HOH. What's the point when you can get a CIC or mini open fit BTE hearing aid and save a fortune and avoid the risks? Additionally, I am seeing people considering CI even though they did NOT max their HAs and/or they are NOT wearing the most powerful HAs. Even my HAs probably aren't maxed out and I am getting them reprogrammed for max gain and enable transposition so I "hear" high frequencies. CI was and still should be a last resort. It's not something you "gotta" have as the latest and greatest or to "upgrade" your perfectly working HAs but as a last and only resort! CI can be better than HA for "off the bat" candidates but it's high risk for "ambigious" candidates, even Shel said 30% of CI users recieve little or no benefit. Daredevel7.................... That 95% is suspect. From reading blogs and talking to others, it appears that 75% are satisfied. Maybe CI does works for 95%, but that doesn't mean everyone with a working CI will be satisfied. There could be all kinds of reasons a quarter of CI wearers aren't satisfied. Just because someone is a candidate doesn't mean itll always work and even if it works that youll be happy and satisfied. That's why people need to do their research and be 100% informed and have realistic expectations. They should also refer to their unaided/aided audiogram and do the math to determine how much better(or worse) a CI will be over what they hear. So you say CI can give a person 50% to 75% speech discrimination? Some HA wearers already get close to that with both HAs in. But they hear environmental sounds great and may in fact hear less environmental sounds with their CI. That could explain one of the reasons for 25% of CI wearers being unhappy. Too much emphasis is placed on speech perception while ignoring the other benefits of HA. If a person hears at 30db and at 90db, they need better HAs or boost the gain. I hear 15db at 250Hz but only 80db at 2000Hz. I am going to get my HAs tested tomorrow at my audiologist then im going to have my other audiologist who sold me those HAs reprogram them and enable transposition so I hear the best I can and should. A person with 50db to 90db sloping loss has a moderate to severe hearing loss. CI is for severe(70db) to profound(90+db) hearing loss. Yes we would be in an uproar at any moderates who somehow qualified for CI. shel90(and others) I always thought the less residual hearing a person has, the better they would be for CI since they have more to gain, less to risk/lose. Even I would seriously consider getting CI if I lost another 10-15db of hearing. This would render me totally deaf above 500Hz and profoundly deaf below 500Hz. At this point, CI would indeed have a 95% chance of being better than what id hear with HAs. Right now with my residual hearing, id give it a 60% chance of being better than HAs(im factoring in environmental sounds too, not just speech) __________________ My reasons for choosing stem cells over CI are numerous. Many thousands have gotten stem cells for all conditions with 90% success rate. I have emailed/contacted stem cell centers, read articles, did my research and know the facts. Chloe got such good results she can hear well without HAs! My hearing loss is the same in both ears. Recent audiogram: 125Hz=55db, 250Hz=70db, 500Hz=90db, 750Hz=110db, 1000Hz-8000Hz=NR at 110db. I discuss my deafness and stem cells in my blog

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03-22-2009, 09:06 AM	#32 (permalink)
Daredevel7 Adrenaline Junky Join Date: Aug 2008 Location: Huntsville, AL Posts: 4,341	There's a lot of talk about loosing up the qualifications of the CI. I don't particularly understand the negativity towards this. Pretend the CI works well for 95% of the population (which it does, but some people don't believe it). When I say works well, I mean they eventually get more than half of speech discrimination. When they started the CI, it was new and experimental, so of course they had restrictions and would only give it to those who had nothing or minimal hearing to lose. After 20 years, and seeing the tremendous success, wouldn't it make sense for them to loosen up and still give the CI to those who DO have residual hearing but have little to no speech discrimination? Hearing at 30dB at a certain frequency doesn't mean ANYTHING if you hear everything else at 90dB. Obviously I am against giving the CI to someone who has enough residual hearing to have relatively good speech discrimination. The problem is when someone says "Oh I have a hearing loss with the range of 50-90dB and I got the CI". Some people get into an uproar, but they interpreted the dB loss as moderate and think they have good enough hearing. That's no better than someone assuming that a HoH can hear everything.

03-22-2009, 11:46 PM	#38 (permalink)
lovezebras Registered User Join Date: May 2006 Location: Canada Posts: 3,963	so ppl who think its the latest fad that will solve their probs are going to be told by their surgeon and ci audi that you need to do therapy etc and if they still get it and don't get what they were wanting cuz they don't do therapy and such then it's their own fault for proceeding with getting a CI

03-23-2009, 01:23 PM	#44 (permalink)
Hear Again Registered User Join Date: Jan 2005 Location: Wisconsin Posts: 20,122 Blog Entries: 6	Yet this lady I know has a 40db sloping HL(NON progressive!) and 60% speech discrimination/perception with both HAs somehow got approved by insurance and her surgeon. She hears unaided much better than you used to hear aided with HAs before you got CIs! That's the exception rather than the rule. The audi who fitted me with my first pair of hearing aids has been in practice since 1985 (perhaps longer than that -- I don't know) and yet she was unfamiliar with CI candidacy criteria. When I asked her if she thought I would qualify, her exact words were, "I don't know. With a 90+ dB loss, you might." By the way, it isn't uncommon for people with good low frequency hearing and severe or profound loss in the mid and high frequencies to be approved for a CI. I know someone who qualifed for a CI that had normal low frequency hearing which sharply dropped to profound in the mid and high frequencies. I agree with faire_jour. Even if this person could hear 60% of speech, what's wrong with opting for a CI when she has the potential to hear 90% or better? Remember too that the world is not a sound proof booth. This person could have had alot of difficulty communicating in background noise. If that was the case, I'm glad she was approved for a CI.

03-23-2009, 01:29 PM	#45 (permalink)
Hear Again Registered User Join Date: Jan 2005 Location: Wisconsin Posts: 20,122 Blog Entries: 6	Still her hearing loss is NOT severe-profound! Nor is it progressive! If criteria has been loosened so much that moderate HL is getting CI, millions of people will try to get CI. How will insurance pay for all those people? They will go out of business! Also there will be a ton of unhappy CI users who hear much worse than they did with HAs. No offense, but what difference does it make to you? If you're happy with hearing aids, good for you. If this person isn't happy with hers, she has every right to decide to get a CI. As for insurance, if they can pay for Viagra, they can pay for CIs too. Insurance companies won't go out of business if they continue paying for CIs. They insure other health conditions -- not just CI evaluations, surgery and mappings. How do you know that someone with a moderate loss would be unhappy with a CI? No one can predict how well a person will hear until after they've received a CI. Besides, research has proven time and time again that people with greater amounts of residual hearing perform very well with a CI.

03-23-2009, 01:33 PM	#46 (permalink)
Hear Again Registered User Join Date: Jan 2005 Location: Wisconsin Posts: 20,122 Blog Entries: 6	She has only moderate hearing loss and hears great with HAs. So now she thinks CI will somehow be better because her insurance and surgeon "said" so. How's that for lax standards and willy-nilly approval? "Only moderate hearing loss." That's funny coming from someone who has had poor hearing all of their life. How do you know what it's like to hear with a moderate hearing loss? Some people with moderate hearing loss have more difficulty understanding speech than those with a severe loss. If her speech discrimination was 60% or less in her better ear and 40% or less in her worse ear, insurance was correct in approving her. Those are the standards that need to be met. End of story.

03-23-2009, 01:35 PM	#47 (permalink)
Hear Again Registered User Join Date: Jan 2005 Location: Wisconsin Posts: 20,122 Blog Entries: 6	She happens to be in that (growing) minority. A minority that may be growing, but is still a minority when compared to the majority.

03-23-2009, 01:40 PM	#50 (permalink)
Hear Again Registered User Join Date: Jan 2005 Location: Wisconsin Posts: 20,122 Blog Entries: 6	A person with 50db to 90db sloping loss has a moderate to severe hearing loss. CI is for severe(70db) to profound(90+db) hearing loss. Not necessarily. If a person has moderately-severe to profound loss in one ear and severe-profound (or profound) in the other in addition to a progressive hearing loss, they would qualify for a CI and rightfully so IMO.

03-23-2009, 01:44 PM	#56 (permalink)
Hear Again Registered User Join Date: Jan 2005 Location: Wisconsin Posts: 20,122 Blog Entries: 6	If a person hears at 30db and at 90db, they need better HAs or boost the gain. This does not account for clarity. I was able to hear at 60-70 dB aided and (against my audi's wishes) I had the gain on my aids increased, but it did absolutely nothing to improve my speech discrimination.