If you are lucky enough to live in North Carolina and you have one of the following happen to you!
What can you do if your child is born deaf?
What can be done if grandpa truly can’t hear a thing?
What if you, a veteran of the latest war, and have lost all hearing due to something not related to the service, like a preference for loud music?
If you or a family member have trouble hearing and it has been determined that you would not be aided by a hearing aid, you may be a candidate for a Cochlear Implant.
A Cochlear Implant is a prosthetic device the bypasses the damaged part of the ear and provides some degree of hearing by stimulating the nerves. The implant has proven successful in restoring a degree of hearing since it was first approved by the FDA two decades ago. Originally there was only one supplier and one version. Over the years a number of companies have come up with new models.
The Cochlear Implant has been proven to restore some degree of hearing to those who are totally deaf and do not have complicating factors that affect the middle ear.
If need an implant and you live in North Carolina, you may be in luck! There are several major medical centers in the area that have experience in this type of surgery. There is also a ready supply of experienced surgeons connected to these medical centers.
Even with an indication that Cochlear implants could work for you, particularly if you are losing hearing due to age. There are many potential barriers to overcome.
Prior to 1985 there was little that could be done for you, if you were completely deaf. There were some experimental versions of what today is known as a Cochlear Implant.
Research has actually been going on in the area of mimicking the sound heard through the middle ear by using electronic implants since the mid 1960s. The first real breakthrough came in May 1972 when Dr. William House installed the first wearable device in a patient. From that point until 1985 there wasn’t an FDA approved Cochlear Implant device.
In 1995 a second version of the Cochlear Implant was approved. This one offered better sound quality by providing more channels. Over the decades, each new version of the Cochlear Implant attempts to improve the quality of sound or the reliability of the system. The current versions allow most totally deaf persons to hear well enough to function in normal conversation.
All current versions of the Cochlear Implant device are a combination of an internal implant and a set of external devices. In order for the hearing nerve to be stimulated a device is surgically implanted in the inner ear. This device is connected by wires to a set of external devices. The external devices may include a micro processor to convert sound to electrical signals to be sent to the implanted device; a battery or battery pack to provide power for the electrical devices; a directional micro phone to pick up sound; and the wire(s) to connect it all.
Just like a hearing aid, people with Cochlear Implants may have the device disconnected or turned off when they don’t feel a need for it.
The implant has been a problem for people who have it and need an MRI scan. One of the most recently introduced models by a local North Carolina company, Med-el of Durham, has been approved in 2005 for use in MRIs.
FDA approval in 1985 and for each new device is one way for potential patients to assess the risk of the operation. This approval was important step for many potential patients, as now insurance could pay for some implants.
Central North Carolina is blessed with a multitude of medical institutions many of which are connected to major education centers. As a result, Central North Carolina residents at there are several places with excellent reputations are located in the Raleigh area including Durham and Chapel Hill. Four of these are Carolina Ear and Hearing Clinic in Raleigh, Duke University Medical Center in Durham, University or North Carolina in Chapel Hill and VA Medical Center in Chapel Hill.
Knowing that you or you family member can benefit from the operation and where the operation can be performed still leaves many things to be addressed.
Cochlear Implants are not right for everyone, even for those who has the right deafness to benefit. There are many issues to come up.
One special group of people that has struggled with Cochlear Implant issues are the deaf community. PBS has created a special documentary on this called “Sound and Fury” which they have available on VHS or DVD. The presentation documents several families who have children born deaf. It shows how hearing parents and deaf parents view the same condition differently. The choice for deaf parents is shown to be much more difficult as in means their children may find themselves separated from their own family, even while it can create opportunities available. For families where deafness is inherited and most family members are deaf, the implant can be a very emotion charged topic.
Assuming the decision is made to go forward. The next issue is whether the person to be operated on has the commitment to follow through with the post operative process. This is considered less of a problem with children than it is with older people. Older people may not want, or not be capable of, putting the effort needed into the learning process. The sounds from the implant will not be exactly like what a fully hearing person is /or was/ used to. Every candidate will need to learn or relearn hearing and speech.
Once the commitment is made the next hurdle is the financial one. A Cochlear Implant is not inexpensive. The patient can expect it to cost in a range from $45,000 to $80,000 without complications just for the surgery. It may cost tens of thousands for pre-testing before and for follow-up testing and training after.
Once the FDA approved the first device 1985, some insurance started paying for the services. Today most insurance covers at least some part of the cost of the operation.
For a person is less than 21 years old in North Carolina Medicaid is likely to pay for it.
For insured persons with private insurance about 90% of the plans provide some coverage for the operation. For active military and covered veterans the VA can pay for the procedure. This will usually be done in a VA hospital.
For those on Medicare this was one of the areas not covered.
For the uninsured whether you are a veteran or not, you have little chance of having the operation paid for. A tiny number of the operations are done on the uninsured.
It is estimated that half of the people who receive the operation are children. Of the other half most are between twenty-one and sixty five.
Medicaid, VA and some insurers may restrict whether you can have a single processor versus a dual processor implant. You may not be able to get the latest technology even if you are approved for payment.
In North Carolina there are a number of places where the operation can be done. There are a lot of advocacy groups that are ready and willing to assist you. In addition, one of the major manufacturers of Cochlear Implants, Med-EL is located in Durham.
To recap: North Carolina is a great state to live in should you need a Cochlear Implant. There are a number of experienced surgeons and quality institutions that offer excellent care. It is easier to get the implant paid for children under 21. Implants are very expensive with just the surgical portion running up to $80,000 with no complications. The decision to have an implant is more difficult for the deaf community than for the hearing community.
Duke University Medical Center
1559 Stead-Blue Zone
Duke South Hospital
Durham, NC 27710
University of North Carolina at Chapel Hill
Children’s Communicative Disorders Program
ENT Clinic, Neurosciences Hospital
Chapel Hill, NC 27514
Universtiy of North Carolina Hospitals and Clinics
101 Manning Drive
Chapel Hill, NC 27514
VA Medical Center – Durham
508 Fulton Street
Durham, NC 27705
Med-El Corporation of Durham NC
3714 Benson Drive, Suite A
Raleigh, NC 27609
Voice/TTY: (919) 850-2746
Voice/TTY: (800) 541-4327 (Calls are free for people in North Carolina)