FAQ
- What is involved in the audiological investigation?
- How long do I have to wait to get a cochlear implant?
- How much will it cost?
- How much hearing loss does someone need before they are considered suitable for a cochlear implant?
- Can someone who was deaf from birth or a young age have a successful cochlear implant?
- What will it be like when I am switched on?
- What will it sound like?
- How often does an implantee need a new MAP?
- Since an implantee needs to have the magnet removed for an MRI, can they have other X-rays or scans?
- Can an implantee go through the security gates at an airport?
- Does the processor need to be switched off while flying?
- I am planning overseas travel, what should I take with me?
- Do I have to limit my sports activity? What about SCUBA diving and swimming?
What is involved in the audiological investigation?
We attempt to ensure that there is no simpler way to assist you to hear. We will ensure that hearing aids are optimized, that other possible devices have been considered and that we believe the cochlear implant is the instrument of choice for you.
The audiological assessment includes;
- Checking if your hearing levels are varying (therefore this requires a number of visits).
- Providing information about the cochlear implant.
- Meeting other people who have had a cochlear implant.
- You and your family may have questions which come to light only after several visits (or after meeting other recipients). We provide you time to ask questions in order to ensure that you have all the information you require.
How long do I have to wait to get a cochlear implant?
Usually there will be a 2 week wait from the time of your referral until the beginning of your medical and audiological assessments. The assessment process usually takes a minimum of 3 months. When both you and our cochlear implant team are happy to go ahead, there is a wait of a few weeks for an operation time.
How much will it cost?
The out of pocket cost for cochlear implant treatment will vary depending on individual circumstances. The following figures are a guide only and may alter with changes in Medicare or Health Fund rebates and government policies.
Inpatient costs are incurred during hospital admission and include hospital accommodation, theatre fees, fees for surgeons and anaesthetists, X-rays and other tests and the cost of the implant. Most of these costs are covered for eligible members by the Private Health Funds, depending on your level of hospital cover and any applicable excess.
Costs incurred outside of hospital may be eligible for a Medicare rebate and may come under the provisions of the Medicare safety net. These include appointments with the surgeon, preoperative audiology assessments, counselling, postoperative switch-on appointments, scans, other tests such as balance tests and other investigations such as general medical assessments.
As a guide, a patient holding a concession card, eligible for the $700 safety net threshold, with no hospital excess, following the usual treatment pathway and with all treatment in the one calendar year would incur a out of pocket cost of about $1200 as of 1 November 2006. This is the minimum cost. A patient without a concession card and with a $1000 safety net threshold would incur an out of pocket cost of about $1900. Additional preoperative assessments and scans could see this rise to $2500 but that is unusual.
Without the Medicare safety net the treatment would cost an additional $1000-$1500. It should be noted that the safety net applies to out of pocket medical expenses incurred outside of hospital in a calendar year. Costs incurred for treatment of other conditions in that year may effectively reduce the cost of cochlear implantation.
How much hearing loss does someone need before they are considered suitable for a cochlear implant?
The criteria are changing over time. Initially, people had to have a total loss in both ears. Nowadays most people need to have a severe to profound loss in both ears. This means they should get little or no benefit from using hearing aids. However, some people with residual low frequency hearing may get little high frequency information from hearing aids and may also be considered for a cochlear implant. Certain people whose hearing shows significant fluctuation may be considered as well.
Can someone with a hearing loss from birth or a young age have a successful cochlear implant?
If the person has not used hearing aids and has not developed good speech and language, then in most cases the higher auditory centres of the brain will not have developed normally. So even if the cochlear implant stimulates the hearing nerve successfully, the brain may not be able to make good use of this incoming information. Generally, such people would not get a good outcome.
However, if the person has been able to access some hearing and developed reasonably good (although reduced) speech and language, there may be a benefit from a cochlear implant. The amount of benefit will still be limited compared to someone who had normal hearing and went deaf in later life. It is highly unlikely that language will improve, and improvements in speech will be very small. Usually it is possible to hear important things better (childrens cries or speaking, warning sounds etc) and in some instances may be able to obtain some better understanding when using lip-reading as well. It is unlikely that hearing will be good enough to understand speech without lip-reading.
What will it be like when I am switched-on?
Despite all the counselling about expectations beforehand, most people maintain high hopes. Switch-on can be a very frustrating and emotionally draining time. The information you hear will not be painful, just different.
What will it sound like?
This is difficult to describe. At the first session, the hearing nerve is usually still awaking to sound, so although sounds may be heard, they may not sound as they should (or even as they will later in the switch-on process). One of our clients said that speech sounded "like an alien duck under water!" Some clients say it sounds terrible at first. Others say it sounds normal. Usually by the end of a month, speech is becoming more like it should be and the message can be understood.
How often does an implantee need a new MAP?
This varies from person to person and from centre to centre. Some centres suggest that adults should decide for themselves when they are in need of a new MAP. Experience suggests that if the person does not get a new MAP some time between once every 3 to 6 months, then they won't be hearing optimally.
Can an implantee have an MRI or other X-rays or scans?
X-rays and CT scans can be performed with a cochlear implant present. In most instances it is possible to erform an MRI scan with the most recent models of cochlear implant just by following some simple precautions. With some older devices it is possible to remove the magnet from the internal part of the device. This will require a minor operation to remove it and another procedure to replace it again after the MRI.
Can an implantee go through the security gates at an airport?
Implantees can go through airport security. However, it is likely that the implant will set off the warning as it also does with some store security systems. It is a good idea to carry a card with you which proves that you have an implanted medical device. These cards are provided for you by Cochlear.
Does the speech processor need to be switched off while flying?
The speech processor does not need to be switched off while flying or during plane landing or take-off.
I am planning overseas travel, what should I take with me? Can I get support from a clinic somewhere else around the world if I need help?
We can give you a computer disk with your MAP information on it so that, should there be a need, you can visit one of the many clinics throughout the world who provide care for implantees. We can also give you a hard copy on paper of your most recent MAP.
If you are travelling, it's a good idea to get the contact details of clinics in the area from your local clinic before you leave. If you forget to do that, the information is available at Cochlear's website.
Do I have to limit my sports activity? What about SCUBA diving and swimming?
Having a cochlear implant will not limit swimming or sports activity. For swimming you will need to remove the external component (ie speech processor) when you swim, much like you would have to remove a hearing aid. The internal part of the cochlear implant is not affected by water. More aggressive or contact sports require you to wear a helmet to protect your equipment. Boxing and other aggressive sports are discouraged.
For SCUBA divers, the internal implant is validated to withstand pressure at a depth of 25 metres (82 feet) underwater. However, it is recommended that you check with your surgeon or clinician before participating in a dive. There may be other medical factors that you will need to consider.