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January 20, 2003

Former Miss America recovers her hearing

From: USA Today - 20 Jan 2003

By Adele Slaughter, Spotlight Health, with medical adviser Stephen A. Shoop, M.D.

In 1995 Heather Whitestone became the first deaf woman to be crowned Miss America. Now she's the first Miss America alum to get a cochlear implant.

"It is important that you are at peace with your decision and have a positive attitude because cochlear implantation is not a cure for deafness," Whitestone advises.

"With the hearing aid, I was able to hear some sounds in my left ear," Whitestone says. "It has helped me to learn to speak, to dance to music, and to listen to other people speaking. I did not consider getting a cochlear implant until my oldest son John fell down in the backyard and cried."

"Unfortunately, I did not hear the sounds coming from the backyard," Whitestone adds. "I was not there to comfort John when he cried. It bothered me tremendously so I prayed to God to give me more hearing. God brought me to considering a cochlear implant."

Whitestone has been deaf since she was 18 months old, after she suffered an extremely high fever and the doctors gave her a life-saving antibiotic that is thought to have caused her hearing loss. Today, she has no recollection of what it was like to hear.

"My main way of communication is oral," Whitestone notes. "I have used my voice to speak about 98% of my life. I learned sign language when I was in 11th grade, but I barely use it because I see hearing people everywhere I go. I also read lips while I listened with the help of hearing aid."

While her cochlear implant was activated this September, it was not an easy decision.

"For six months, I asked different professional people tons of questions," Whitestone says. "I spoke to people who had lost their hearing at least a year before they had received a cochlear implant. They all said that the sounds they heard were similar to what they heard before they lost their hearing."

Crowning moment

"Somewhere around 10 to 12% of Americans — about 27 million people — have a hearing loss that prevents them from hearing speech in most group settings," John Niparko reports, professor of otology and neuro-otology, Johns Hopkins University School of Medicine. That means that in a restaurant, or a party, or an environment with a lot of people they have difficulty understanding speech."

There are two different types of hearing loss: conductive and sensorineural.

Conductive is caused by a problem in the outer or middle ear. In this type of hearing loss, the sound cannot reach the nerves in the inner ear.

Sensorineural hearing loss is the result of damage to some or all of the small hair cells in the cochlea, which are responsible for changing sound into electric pulses that are in turn translated by the brain. It also can result from direct injury to the auditory (hearing) nerve, which carries the electric impulses to the brain. This particular type of hearing loss can happen before or during birth as well as later in life. Some of the common reasons for such hearing loss include:

* Perinatal infections * Heredity * Lack of oxygen at birth * Low birth weight * Head and neck birth defects

Late onset of sensorineural hearing loss can be caused by:

* Bacterial meningitis * Drug induced ototoxicity (damage to hearing) * Excessive noise * Physical damage to head or ear

When hearing loss does occur, hearing aids can help amplify sound. But individuals whose hearing loss is more severe may not get sufficient help from a hearing aid.

"About 1% — or 2.5 million Americans — is functionally deaf. Of those individuals it is thought that about one-third could benefit from a cochlear implant. That's about 700,000 people," Niparko says. "Today in the US about 32,000 people have a cochlear implant."

Our ideal

The cochlear implant bypasses the cells that are responsible for taking the energy and sound and converting that into a nerve signal. The implant takes the sound and converts it into an electrical code, which is transferred directly to the hearing nerve. Then the brain interprets that code, which is similar to the code normally produced by sound.

"We know that adults who have had shorter periods of deafness are more likely to be able to use the information that the implant provides to understand speech," Niparko explains. "For children who are born deaf, early intervention results in a much greater benefit from the implant."

The surgery to insert the implant is an outpatient procedure that lasts about an hour and a half. The cochlear implant system costs about $24,000. Implant surgery runs about $8,000 making the total cost of getting a cochlear implant around $32,000.

"It's the cost of an automobile," Niparko says. "But this one is designed to last 120 years. And only about 1% of them need to be replaced because of circuit failure of some sort."

"In the surgery we open up the mastoid behind the ear canal," Niparko explains. "We expose the inner ear and place the electrode array around the hearing nerve through the inner ear and secure the device under the skin, and close up. After a period of healing which takes about a month, the device is activated by an external computer."

Learning how to understand the sounds is the next step.

"The brain is a quite amazing organ in that it does some of the work on its own," Jennifer Yeagele says, Whitestone's audiologist. "We basically give her tools in how to focus on a sound that might be giving her more difficulty. It is a process and takes time and effort on the part of the patient and the team working with them. The patient has to be motivated and recognize that they won't be able to walk out and in six months never need to see their audiologist again. It's a life long journey."

Since her implant has been activated, it's been music to Whitestone's ear.

"I was listening to the audio book cassette of Goodnight Moon with my boys and my husband John," Whitestone says. "My oldest son repeated the words. I could not understand most of the words he said, but I understood and heard two words perfectly. He said, 'Goodnight Moon.' These were my first words I understood with the cochlear implant alone."

"I hear more fussing from my boys, but it helps me to be a better mom," Whitestone adds. "For example, I was in my bedroom for a minute. I heard fast running water. I immediately checked the bathroom down the hall and noticed that my two boys climbed into the bathtub. I was able to catch them before anything happened to them. A year ago, I would not have heard the running water from the bathtub even when I wore my hearing aid."

For those considering a cochlear implant, Whitestone offers her Miss America optimism combined with her own brand of realism.

"It is important that you are at peace with your decision and have a positive attitude because cochlear implantation is not a cure for deafness," Whitestone advises. "It takes time and patience to work with the cochlear implant. Yes, my cochlear implant is working beautifully, but it does not cure my deafness. It brings sounds to my right ear, sounds I never heard before, even with a hearing aid, for 28 years."

� Copyright 2003 USA TODAY, a division of Gannett Co. Inc.