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May 13, 2003

Listening lessons follow ear-implant surgery

From: Lowell Sun, MA - May 13, 2003

Acton woman adjusting to sounds she hasn't heard well in 30-plus years
By PETER WARD, Sun Staff

ACTON On a warm spring night, through an open window she could hear a low rumbling noise.

She asked her husband, Phil, if it was a train. They live a quarter-mile from the South Acton commuter station.

He smiled.

"I finally heard the train," Joan Davis said.

Some might take the sound of a distant train for granted, but for Davis, it signified a breathtaking turnabout.

In December, she underwent a surgical procedure in which a doctor inserted a cochlear implant in her inner ear.

As a result, her right ear, which she described as "dead" ever since a bout of meningitis as a toddler, was now able to pick out sounds.

"She's doing fabulous for an ear that hadn't had its auditory nerves stimulated in 30-plus years," said Sarah Poissant, a clinical and research director at UMass Medical Center in Worcester. "She has what we call open-set speech understanding, which means we can say things to her when she's not looking at me and she can understand. But it's not up to 100 percent yet."

With the implant, Davis doesn't hear in the conventional sense. Unlike a hearing aid that amplifies sound, the cochlear implant simulates the natural, complex relationship between the ear and brain.

The device's microphone, attached just behind the ear, catches sound and converts it to electrical impulses that stimulate nerves leading from the inner ear's snail-shaped cochlea. The brain then translates those impulses into recognizable sounds.

Davis recently replaced the first unit, which included a speech processor worn on the belt, with a smaller wireless device behind the ear.

Only 50,000 people have cochlear implants. Davis got hers at the 4-year-old cochlear implant program at UMass, which is monitoring more than 100 patients.

"Joan is doing great," said Dr. Dan Lee, the program's director and Davis' surgeon. "She's healed up beautifully, and she's learning to hear day by day."

"The quality of sound is like night and day," Davis said, comparing it to the days before the operation, when she used only a hearing aid in the so-called good ear. "Crystal clear."

Even so, for Davis, a 39-year-old married mother of three, the procedure was not without some hardship, setback and pain.

During the first few weeks with the implant, the nerve stimulation going on in her head was too much to bear.

"Any noise I heard made me tense, on edge, irritable. I felt as if I was jumping out of my skin," said Davis.

Words sounded like banging, she said.

"I went back to the audiologists and said, 'I'm grateful for what you've done, but I don't like it.'"

At times she had to rely on her religious faith and the emotional support she received from fellow parishioners at the nearby Mount Calvary Lutheran Church. In a prayer at one point she said to God, "I don't know if this will work but you take it from here."

Later on, though her hearing was improving, she was still misunderstanding words. Especially troubling were words that begin with consonants that precede the long "e" vowel sound words such as "beat" or "leap."

To her surprise, the problem was remedied easily.

At a checkup, Poissant, the audiologist, clicked a few keys on the computer keyboard, adjusting the sensitivity level of some of the device's 20 electrodes.

It made Davis marvel at how her progress was aided by the technological advances of strangers "all those computer people sitting around the water cooler talking about this stuff. I'm thankful to them."

As her hearing has improved, Davis has experienced inconvenience.

Before the procedure, for instance, she was adept at using the telephone because she was wearing a hearing aid on the left ear. But now, as she works to adjust to the implant, she was advised to give the hearing aid a rest. As a result, she's avoided the phone, relying instead on e-mail.

"You can't lip-read on the phone. You're totally reliant on hearing," she said.

Having a more acute sense of hearing can at times be perilous.

Making tea one day she heard the steam kettle, took it off the stove and made her tea. But the tea was cool.

She solved the mystery.

"With my hearing aid, I could hear it when it was a rolling boil," she said, "but with the implant, I was hearing it sooner."

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