The hearing and cochlear implant debate! Share your opinion!

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)
 
Hear Again said:
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%.
Click to expand...

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.

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?
Click to expand...

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.

Hear Again said:
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.
Click to expand...

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.

Hear Again said:
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.
Click to expand...

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?

Hear Again said:
If anyone opts for a CI because it's "the latest and greatest technology," they are a very small minority of CI candidates.
Click to expand...

She happens to be in that (growing) minority.
 
deafdude1 said:
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.
Click to expand...

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.
 
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.
 
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.
 
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.
 
She happens to be in that (growing) minority.

A minority that may be growing, but is still a minority when compared to the majority.
 
Hear Again said:
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.
Click to expand...

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).
 
faire_jour said:
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. .
Click to expand...

I personally know two, both in their twenties. No residual hearing after surgery and a poor CI result.
 
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 said:
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).
Click to expand...

:gpost:
 
faire_jour said:
But they heard well with their hearing aids? They did their follow up therapy and MAPing?
Click to expand...

Of course the follow up therapy and MAPs. Not well with aids, but some, which to me is better than nothing.
 
Hear Again said:
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.
Click to expand...

I am curious, do you get paid or get benefit from advocating for CI?
 
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 said:
I am curious, do you get paid or get benefit from advocating for CI?
Click to expand...

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

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.
 
Back
Top